Arthroscopic portals: the importance of blade selection

Arthroscopy of the knee is a commonly performed procedure with a low reported complication rate. We have experienced two cases during which no. 15 scalpel blades disengaged from the handle and remained within the joint. Although both the blades were successfully retrieved arthroscopically without injury to the knee, the procedures were prolonged, and there remained a potential risk of causing damage. We have subsequently altered our practice and now routinely use a no. 11 blade, with which we have had no complications. We discuss the importance of correct blade selection and surgical technique in avoiding this complication and present two illustrative case histories.