Performance of arthroscopic irrigation systems assessed with automatic blood detection
Identifieur interne : 001990 ( Ncbi/Curation ); précédent : 001989; suivant : 001991Performance of arthroscopic irrigation systems assessed with automatic blood detection
Auteurs : G. J. M. Tuijthof [Pays-Bas] ; M. M. De Vaal [Pays-Bas] ; I. N. Sierevelt [Pays-Bas] ; L. Blankevoort [Pays-Bas] ; M. P. J. Van Der List [Pays-Bas]Source :
- Knee Surgery, Sports Traumatology, Arthroscopy [ 0942-2056 ] ; 2011.
Abstract
During arthroscopies, bleeding episodes occur as a result of tissue damage. Irrigation systems assist in minimizing these disturbances. The performance of three arthroscopic irrigation systems in clearing bleeding episodes was evaluated objectively.
One surgeon performed 99 shoulder arthroscopies using three irrigation systems: gravity infusion, single roller, and double roller pump. The three irrigation systems groups were matched postoperatively for type of surgery-acromioplasty, SLAP, release, rotator cuff repair and capsule repair, and operation duration. The recorded arthroscopies were analyzed for the presence of bleeding episodes with a special computer program that automatically detects the tinctures of red-colored blood. A least 20% of an arthroscopic image had to be covered with blood to qualify as bleeding episode.
The median (min–max) presence of bleeding episodes as a percentage of the operation time was 6.6% (0.0–43.6%) for gravity infusion, 3.7% (0.2–46.4%) for the single roller, and 3.3% (0.0–19.3%) for the double roller pump, respectively. The large variation could be attributed to the occurrence of arterial bleeding episodes during some procedures. No significant differences were found between the irrigation systems. For a subgroup including acromioplasties and releases, significant differences were found in favor of both roller pumps (
Overall, the roller pumps did not outperform gravity infusion. However, from the results, high-risk procedures for bleeding episodes were identified (acromioplasty and release of a frozen shoulder) that can benefit from the use of roller pumps. A clear view is essential to perform an arthroscopic procedure safely and efficiently.
III.
Url:
DOI: 10.1007/s00167-011-1495-z
PubMed: 21479643
PubMed Central: 3195766
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Tuijthof</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, fac. of 3ME, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, fac. of 3ME, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="De Vaal, M M" sort="De Vaal, M M" uniqKey="De Vaal M" first="M. M." last="De Vaal">M. M. De Vaal</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Sierevelt, I N" sort="Sierevelt, I N" uniqKey="Sierevelt I" first="I. N." last="Sierevelt">I. N. Sierevelt</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Blankevoort, L" sort="Blankevoort, L" uniqKey="Blankevoort L" first="L." last="Blankevoort">L. Blankevoort</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Van Der List, M P J" sort="Van Der List, M P J" uniqKey="Van Der List M" first="M. P. J." last="Van Der List">M. P. J. 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J. M." last="Tuijthof">G. J. M. Tuijthof</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, fac. of 3ME, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, fac. of 3ME, Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea><wicri:noRegion>2628 CD Delft</wicri:noRegion></affiliation></author><author><name sortKey="De Vaal, M M" sort="De Vaal, M M" uniqKey="De Vaal M" first="M. M." last="De Vaal">M. M. De Vaal</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Sierevelt, I N" sort="Sierevelt, I N" uniqKey="Sierevelt I" first="I. N." last="Sierevelt">I. N. Sierevelt</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Blankevoort, L" sort="Blankevoort, L" uniqKey="Blankevoort L" first="L." last="Blankevoort">L. Blankevoort</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea><wicri:noRegion>1105 AZ Amsterdam</wicri:noRegion></affiliation></author><author><name sortKey="Van Der List, M P J" sort="Van Der List, M P J" uniqKey="Van Der List M" first="M. P. J." last="Van Der List">M. P. J. Van Der List</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Bergman Medical Care, Prof. Bronkhorstlaan 10, 3723 MB Bilthoven, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Bergman Medical Care, Prof. Bronkhorstlaan 10, 3723 MB Bilthoven</wicri:regionArea><wicri:noRegion>3723 MB Bilthoven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">Former Meander Medical Centre, Baarn, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Former Meander Medical Centre, Baarn</wicri:regionArea><wicri:noRegion>Baarn</wicri:noRegion></affiliation></author></analytic><series><title level="j">Knee Surgery, Sports Traumatology, Arthroscopy</title><idno type="ISSN">0942-2056</idno><idno type="eISSN">1433-7347</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>During arthroscopies, bleeding episodes occur as a result of tissue damage. Irrigation systems assist in minimizing these disturbances. The performance of three arthroscopic irrigation systems in clearing bleeding episodes was evaluated objectively.</p></sec><sec><title>Methods</title><p>One surgeon performed 99 shoulder arthroscopies using three irrigation systems: gravity infusion, single roller, and double roller pump. The three irrigation systems groups were matched postoperatively for type of surgery-acromioplasty, SLAP, release, rotator cuff repair and capsule repair, and operation duration. The recorded arthroscopies were analyzed for the presence of bleeding episodes with a special computer program that automatically detects the tinctures of red-colored blood. A least 20% of an arthroscopic image had to be covered with blood to qualify as bleeding episode.</p></sec><sec><title>Results</title><p>The median (min–max) presence of bleeding episodes as a percentage of the operation time was 6.6% (0.0–43.6%) for gravity infusion, 3.7% (0.2–46.4%) for the single roller, and 3.3% (0.0–19.3%) for the double roller pump, respectively. The large variation could be attributed to the occurrence of arterial bleeding episodes during some procedures. No significant differences were found between the irrigation systems. For a subgroup including acromioplasties and releases, significant differences were found in favor of both roller pumps (<italic>P</italic> < 0.05).</p></sec><sec><title>Conclusions</title><p>Overall, the roller pumps did not outperform gravity infusion. However, from the results, high-risk procedures for bleeding episodes were identified (acromioplasty and release of a frozen shoulder) that can benefit from the use of roller pumps. A clear view is essential to perform an arthroscopic procedure safely and efficiently.</p></sec><sec><title>Level of evidence</title><p>III.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ampat, G" uniqKey="Ampat G">G Ampat</name></author><author><name sortKey="Bruguera, J" uniqKey="Bruguera J">J Bruguera</name></author><author><name sortKey="Copeland, Sa" uniqKey="Copeland S">SA Copeland</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chami, G" uniqKey="Chami G">G Chami</name></author><author><name sortKey="Ward, Jw" uniqKey="Ward J">JW Ward</name></author><author><name sortKey="Phillips, R" uniqKey="Phillips R">R Phillips</name></author><author><name sortKey="Sherman, Kp" uniqKey="Sherman K">KP Sherman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Di Gennaro, Gl" uniqKey="Di Gennaro G">GL Di Gennaro</name></author><author><name sortKey="Bettuzzi, C" 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