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Fundamentals of Arthroscopy Fluid Management and Strategies to Safely Improve Visualization
Rafael Walker-Santiago1, David R Maldonado, Benjamin G Domb
1From the American Hip Institute Research Foundation, Chicago, IL (Maldonado, Domb, and Lall), AMITA Health St. Alexius Medical Center, Hoffman Estates, IL (Domb and Lall), the American Hip Institute, Chicago, IL (Domb and Lall), Aurora Medical Center, Grafton, WI (Walker-Santiago), and Aurora Sinai Medical Center, Milwaukee, WI (Walker-Santiago).
Abstract:
Arthroscopy has become increasingly relevant to various subspecialties within the orthopaedic surgery. From a patient safety standpoint and surgical efficiency standpoint, it is critical to know the fundamental concepts of fluid management such as those related to the fluid, pressure, and flow. A satisfactory field of view during arthroscopy can be achieved with the use of gravity-dependent or automated fluid management systems. Fluid management parameters and their physiological impact on the patient should be continuously monitored to avoid morbidity or delayed recovery. Local and systemic complications can occur from careless use of techniques that improve visualization such as tourniquet, epinephrine-diluted irrigation, and controlled hypotensive anesthesia. The purpose of this article is to review the fundamental concepts of fluid management in arthroscopy and the techniques to safely improve arthroscopic visualization.
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