Should We Suture Arthroscopic Portals? Effects on Intra-articular Fluid Retention

Area of Science:

• Orthopaedics
• Sports Medicine
• Surgical Procedures

Background:

• Knee arthroscopy is a common orthopedic procedure with reported issues of portal problems and post-operative effusion.
• Current research on portal management primarily focuses on wound healing and aesthetics, with limited data on irrigation fluid retention and effusion.
• The impact of irrigation fluid retention on clinical outcomes after knee arthroscopy remains unclear, lacking consensus on optimal portal management.

Purpose of the Study:

• To investigate whether irrigation fluid is retained within the knee joint after arthroscopy.
• To determine if portal-closure management influences post-operative effusion.
• To evaluate the effect of different portal management techniques on patient outcomes.

Main Methods:

• A randomized, prospective study involving 91 patients undergoing knee arthroscopy.
• Patients were divided into two groups: sutured-portal (46 patients) and open-portal (45 patients).
• Intra-articular fluid collection was assessed using suprapatellar knee-diameter measurements and dressing change frequency; clinical outcomes were evaluated using VAS, Oxford knee, and Knee Society scores.

Main Results:

• All portal wounds healed without complications, and no infections were observed in either group.
• No significant differences were found in visual analog scale (VAS), Oxford knee, or Knee Society scores between the sutured-portal and open-portal groups.
• A statistically significant reduction in knee diameter was observed in the open-portal group compared to the sutured-portal group, indicating less fluid retention. The open-portal group also required fewer dressing changes within the first 24 hours.

Conclusions:

• Leaving knee arthroscopy portals open with a simple dressing may be an effective strategy for preventing intra-articular fluid retention.
• This approach can potentially reduce post-operative effusion and improve patient comfort.
• The study recommends considering open-portal management for selected patients undergoing knee arthroscopy to mitigate fluid retention issues.