Información del artículo
When it comes to performing a safe arthroscopic procedure, obtaining an optimal view of the surgical field is essential. For this, a proper functioning of the optical systems and an appropriate distension of the joint are required. With this goal in mind, irrigation systems have been developed that inject fluid into the joint during the arthroscopic procedure. The pressure exerted by the fluid distends the joint space, while the fluid itself removes any wear debris or blood found in the surgical field and keeps the soft tissues apart. In this way, a clear view can be obtained of the whole area. In addition to gravity irrigation systems with or without a pressurized bag, automatic infusion pumps can also be used.
Key words:
irrigation
arthroscopy
gravity
infusion pump
joint distension
A la hora de realizar un procedimiento artroscópico de manera segura es esencial una visualización óptima; para ello es necesario un correcto funcionamiento del sistema óptico y una adecuada distensión articular. Con este propósito se han diseñado sistemas de irrigación que introducen líquido en la articulación durante la artroscopia. La presión del líquido de irrigación distiende el espacio articular, mientras el flujo elimina detritus o sangre y mantiene apartados los tejidos blandos. De esta manera puede obtenerse y mantenerse un campo visual nítido. Además de los sistemas de irrigación por gravedad, con o sin bolsas presurizadas, pueden emplearse bombas automáticas de perfusión.
Palabras clave:
irrigación
artroscopia
gravedad
bomba de perfusión
distensión articular
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References
[2.]
T. Muellner, W.A. Menth-Chiari, R. Reihsner, J. Eberhardsteiner, L. Engebretsen.
Accuracy of pressure and flow capacities of four arthroscopic fluid management systems.
Arthroscopy, 17 (2001), pp. 760-764
[3.]
D.J. Ogilvie-Harris, L. Weisleder.
Fluid pump systems for arthroscopy: a comparison of pressure control versus pressure and flow control.
Arthroscopy, 11 (1995), pp. 591-595
[4.]
G.J. Tuijthof, L. Dusse, J.L. Herder, C.N. van Dijk, P.V. Pistecky.
Behavior of arthroscopic irrigation systems.
Knee Surg Sports Traumatol Arthrosc, 13 (2005), pp. 238-246
[5.]
J.W. Ewing, D.A. Noe, H.B. Kitaoka, M.J. Askew.
Intra-articular pressures during arthroscopy knee surgery.
Arthroscopy, 2 (1986), pp. 264-269
[6.]
N. Oretorp, S. Elmersson.
Arthroscopy and irrigation control.
Arthroscopy, 2 (1986), pp. 46-50
[7.]
M. Bauer, R.W. Jackson.
Intra-articular pressure in the knee during routine arthroscopy.
Arthroscopy, 2 (1986), pp. 198-199
[8.]
J.B. McGinty, S.S. Burkhart, R.W. Jackson, D.H. Johnson, J.C. Richmond.
Artroscopia quirúrgica.
Marbán, (2005),
[9.]
R. Bergstrom, J. Gillquist.
The use of an infusion pump in arthroscopy.
Arthroscopy, 2 (1986), pp. 41-45
[10.]
N. Halperin, A. Axer, E. Hirschberg, M. Agasi.
Arthroscopy of the knee under local anesthesia and controlled pressure irrigation.
Clin Orthop Relat Res, 134 (1978), pp. 176-179
[11.]
J.A. Davison, A.E. Strover.
A technique for prevention of sudden pressure loss on emptying of irrigation bags during arthroscopy surgery using gravity-fed irrigation systems.
Arthroscopy, 9 (1993), pp. 336-337
[12.]
J.H. Kim, K.I. Ha, J.H. Ahn, S.H. Kim, I. Oh.
A water-infusion system with two reservoirs at different levels.
Arthroscopy, 18 (2002), pp. 446-449
[13.]
T. Dolk, B.G. Augustini.
Three irrigation systems for motorized arthroscopic surgery: a comparative experimental and clinical study.
Arthroscopy, 5 (1989), pp. 304-314
[14.]
J. Gillquist, G. Hagberg, N. Oretorp.
Arthroscopy in acute injuries of the knee.
Orthop Scand, 48 (1977), pp. 190
[15.]
G. Ampat, J. Bruguera, S.A. Copeland.
Aquaflo pump vs FMS 4 pump for shoulder arthroscopic surgery.
Ann R Coll Surg Engl, 79 (1997), pp. 341-344
[16.]
A. Guyton.
Textbook of medical physiology.
WB Saunders, (1961),
[17.]
D.S. Morrison, R.K. Schaefer, R.L. Friedman.
The relationship between subacromial space pressure, blood pressure, and visual clarity during arthroscopic subacromial decompression.
Arthroscopy, 11 (1995), pp. 557-560
[18.]
F.R. Noyes, E.S. Spievack.
Extraarticular fluid dissection in tissues during arthroscopy.
Am J Sports Med, 10 (1982), pp. 346-351
[19.]
S. Herrero, J. Vaquero.
La irrigación por gravedad en artroscopia.
Artroscopia, 1 (1991), pp. 25-29
[20.]
T. Dolk, B.G. Augustini.
Elevated position of suction outflow during arthroscopic motorized surgery: an experimental study.
Arthroscopy, 5 (1989), pp. 97-100
[21.]
G. Arangio, K.E. Kostelnik.
Intraarticular pressures in a gravity-fed arthroscopy fluid delivery system.
Arthroscopy, 8 (1992), pp. 341-344
[22.]
J. Jerosch, W.H. Castro, B. Geske.
Intracompartmental pressure in the lower extremity after arthroscopic surgery.
Acta Orthop Belg, 57 (1991), pp. 97-101
[23.]
T. Lind, P.J. Blyme, H.H. Strange-Vognsen, J. Bagger.
Pressure-position relations in glenohumeral joint.
Acta Orthop Belg, 58 (1992), pp. 81-83
[24.]
M.G. Siegel.
Compartment syndrome after arthroscopic surgery of the knee. A report of two cases managed nonoperatively.
Am J Sports Med, 25 (1997), pp. 123-125
[25.]
R.D. Peek, D.W. Haynes.
Compartment syndrome as a complication of arthroscopy.
Am J Sports Med, 12 (1984), pp. 464-468
[26.]
V. Fruensgaard, A. Holm.
Compartment syndrome complicating arthroscopy surgery.
J Bone Joint Surg Br, 70B (1988), pp. 146-147
[27.]
L.S. Matthews, P. Fadale.
Subacromial anatomy for the arthroscopist.
Arthroscopy, 5 (1989), pp. 36-40
[28.]
A.D. Olszewski, R. Jones, R. Farrel, K. Kaylor.
The effects of dilute epinephrine saline irrigation on the need for tourniquet use in routine arthroscopic knee surgery.
Am J Sports Med, 27 (1999), pp. 354-356
[29.]
K.H. Jensen, K. Wether, V. Stryger, K. Schultz, B. Falkenberg.
Arthroscopic shoulder surgery with epinephrine saline irrigation.
Arthroscopy, 17 (2001), pp. 578-581
[30.]
S.S. Burkhart, S.M. Danaceau, K.A. Athanasiou.
Turbulence control as a factor in improving visualization during subacromial shoulder arthroscopy.
Arthroscopy, 17 (2001), pp. 209-212
[31.]
J.L. Martínez, J. Vaquero.
L’irrigation articulaire en arthroscopie.
Int Orthop, 10 (1986), pp. 101-104
[32.]
Y.F. Lee, L. Cohn, S.M. Tooke.
Intramuscular deltoid pressure during shoulder arthroscopy.
Arthroscopy, 5 (1989), pp. 209-212
[33.]
D.J. Ogilvie Harris, E. Boynton.
Arthroscopic acromioplasty: Extravasation of fluid into the deltoid muscle.
Arthroscopy, 6 (1990), pp. 52-54
[34.]
C.F. Carr, J.M. Murphy.
Deltoid and supraspinatus muscle pressures following various arthroscopic shoulder procedures.
Arthroscopy, 11 (1995), pp. 401-403
[35.]
A. Amendola, K. Faber, K. Willits, A. Miniaci, S. Labib, P. Fowler.
Compartment pressure monitoring during anterior cruciate ligament reconstruction.
Arthroscopy, 15 (1999), pp. 607-612
[36.]
E.F. Ekman, G.G. Poehling.
An experimental assessment of the risk of compartment syndrome during knee arthroscopy.
Arthroscopy, 12 (1996), pp. 193-199
[37.]
B.C. Bomberg, P.E. Hurley, C.A. Clark, C.S. McLaughlin.
Complications associated with the use of an infusion puma during knee arthroscopy.
Arthroscopy, 8 (1992), pp. 224-228
[38.]
V.J. DiStefano, V.R. Kalman, J.S. O’Malley.
Femoral nerve palsy after arthroscopic surgery with an infusion pump irrigation system. A report of three cases.
Am J Orthop, 25 (1996), pp. 145-148
[39.]
J. Romero, C.M. Smit, M. Zanetti.
Massive intraperitoneal and extraperitoneal accumulation of irrigation fluid as a complication during knee arthroscopy.
Arthroscopy, 14 (1998), pp. 401-404
[40.]
A. Sperber, T. Wredmark.
Intramuscular pressure and fluid absorption during arthroscopic acromioplasty.
J Shoulder Elbow Surg, 8 (1999), pp. 414-418
[41.]
I.K. Lo, S.S. Burkhart.
Immediate postoperative fluid retention and weight gain after shoulder arthoscopy.
Arthroscopy, 21 (2005), pp. 605-610
[42.]
L.U. Bigliani, E.L. Flatow, E.D. Deliz.
Complications of shoulder arthroscopy.
Orthop Rev, 20 (1991), pp. 743-751
[43.]
S.C. Weber, J.S. Abrams, W.M. Nottage.
Complications associated with arthroscopic shoulder surgery.
Arthroscopy, 18 (2002), pp. 88-95
[44.]
K.D. Mohammed, M.G. Hayes, A.D. Saies.
Unusual complications of shoulder arthroscopy.
J Shoulder Elbow Surg, 9 (2000), pp. 350-352
[45.]
J.C. Rodríguez, M. Mendoza, J. Cobo.
Complicaciones en la artroscopia de hombro.
Cuadernos de artroscopia, 1 (1994), pp. 25-29
[46.]
H.C. Lee, N. Dewan, L. Crosby.
Subcutaneous emphysema, pneumomediastinum, and potentially fife-threatening tension pneumopthorax. Pulmonary complications from arthroscopic shoulder decompression.
Chest, 101 (1992), pp. 1265-1267
[47.]
K.Y. Lau.
Pneumomediastinum caused by subcutaneous emphysema in the shoulder. A rare complication of arthroscopy.
Chest, 103 (1993), pp. 1606-1607
[48.]
A. Borgeat, P. Bird, G. Ekatodramis, C. Dumont.
Tracheal compression caused by periarticular fluid accumulation: A rare complication of shoulder surgery.
J Shoulder Elbow Surg, 9 (2000), pp. 443-445
[49.]
J.M. Hynson, A. Tung, J.E. Guevara, J.A. Katz, J.M. Glick, W.A. Shapiro.
Complete airway obstruction during arthroscopy shoulder surgery.
Anesth Analg, 76 (1993), pp. 875-878
[50.]
P. Berjano, B.G. González, J.F. Olmedo, L.A. Pérez-España, M.G. Munilla.
Complications in arthroscopy shoulder surgery.
Arthroscopy, 14 (1998), pp. 785-788
[51.]
J. De Wachter, F. Van Glabbeek, R. van Riet, W. Van Leemput, K. Vermeyen, J. Somville.
Surrounding soft tissue pressure during shoulder arthroscopy.
Acta Orthop Belg, 71 (2005), pp. 521-527
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