High Variability in Arthroscopic Fluid Use Among Surgeons and Joints for Common Orthopaedic Procedures.

Area of Science:

• Orthopaedic Surgery
• Surgical Efficiency
• Resource Management

Background:

• Arthroscopic procedures utilize significant fluid volumes, impacting surgical costs and waste.
• Optimizing fluid use is crucial, especially during periods of resource constraint.
• Understanding fluid consumption patterns is key to improving efficiency in elective orthopaedic surgery.

Purpose of the Study:

• To analyze arthroscopic fluid volume use across common elective orthopaedic procedures.
• To evaluate intersurgeon consistency in fluid consumption patterns.
• To assess the impact of blood loss reduction adjuncts on fluid usage.

Main Methods:

• A cross-sectional analysis of 449 adult arthroscopic cases (shoulder, knee, elbow, ankle) at an outpatient surgery center.
• Fluid use was analyzed relative to body area, procedure type, surgeon, and use of tranexamic acid (TXA) or epinephrine.
• Analysis of variance tests were employed to determine statistical significance.

Main Results:

• Shoulder arthroscopy had the highest mean fluid volume (16,582 mL), followed by knee (8,677 mL), elbow (6,489 mL), and ankle (3,534 mL).
• Significant intersurgeon variation in fluid use was observed (P = .0001).
• Neither epinephrine nor TXA demonstrated a significant reduction in overall fluid consumption (P > .05).

Conclusions:

• Arthroscopic fluid consumption varies widely across anatomical regions and between surgeons.
• Current adjuncts like epinephrine and TXA did not significantly decrease fluid use in this cohort.
• Further research with standardized protocols may be needed to confirm the efficacy of adjuncts in reducing fluid consumption.