Arthroscopy and Arthroscopic Surgery in a Gas Versus a Fluid Medium

Eriksson, Ejnar; Sebik, Ahmet

doi:10.1016/s0030-5898(20)30713-6

Cited by 32 publications

(11 citation statements)

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“…Although many authors agree with the advantages of gas over fluid in terms of quality of vision and technical comfort [5, 8, 10, 11, 13, 18, 19, 22, 23], we have no objective means to quantify the potential advantages of improved visualization.…”

Section: Discussionmentioning

confidence: 99%

“…2) and avoiding reduced vision due to bleeding, synovial villi and floating debris (Fig. 3) [5, 8, 10, 11, 13, 18, 19, 22, 23]. For Henche [8]: “The advantage of gas filling lies in the natural appearance of the interior of the knee joint.…”

Section: Introductionmentioning

confidence: 99%

“…For Henche [8]: “The advantage of gas filling lies in the natural appearance of the interior of the knee joint. There is always a clear view, and if bleeding of the synovial membrane occurs it does not blur the image.” At the same time, for Eriksson and Sebik [5], advantages of gas medium are “improved clarity and the ability to make a more realistic assessment of joint surface pathology” and for Johnson [11] an “increase field of vision.” More recently, Strobel [22] mentioned “good visibility, good depth of field and does not disturb the synovial villi” to describe gas advantages in a rigorous comparison between gas and fluid arthroscopy (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A risk–benefit analysis of alternating low-pressure CO2 insufflation and fluid medium in arthroscopic knee ACL reconstruction

Imbert

Schlatterer

2013

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A risk–benefit analysis of alternating low-pressure CO2 insufflation and fluid medium in arthroscopic knee ACL reconstruction

Imbert

Schlatterer

2013

Knee Surg Sports Traumatol Arthrosc

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“…S ince the early days of elbow arthroscopy, indications and techniques have evolved from a simple diagnostic procedure and removal of loose bodies to advanced cartilage and fracture treatment and such. [1][2][3][4][5][6][7] Some years ago, I was happy to attend an instructional course given by our Editor-in-Chief Emeritus Gary Poehling, who made a strong impact on the development of arthroscopic techniques, especially of the small joints. He told us beginners struggling with orientation and the complex arthroscopic anatomy, "Maybe it's helpful to think of the elbow like if it were a little knee."…”

Section: See Related Article On Page 1958mentioning

confidence: 99%

Editorial Commentary: Elbow Arthroscopy in the Pediatric Patient—Small Lesions in a Small Joint but With a Big Impact

Kircher¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Elbow arthroscopy has evolved to be a powerful tool for the treatment of a broad spectrum of pathologies over the past almost 40 years. The small joint with a complex arthroscopic anatomy demands special training and exceptional skills from the orthopaedic surgeon. On the basis of this fact and in light of the close proximity of the neurovascular structures, complication rates are somewhat higher compared with other large joints such as the knee and the shoulder. Nevertheless, elbow arthroscopy has also found its way into the treatment of joint pathologies in pediatric patients. The spectrum of pathologies differs from that in the adult population, with fewer degenerative changes and many growthrelated issues such as osteochondral lesions (osteochondritis dissecans) of the capitellum. Generally speaking, clinical outcomes, return to sports, and patient satisfaction are excellent and complication rates are low. The latter remains a target for further improvement in light of the many years those pediatric elbow joints have ahead.The authors report the following potential conflicts of interest or sources of funding: J.K. has a leadership position/advisory role as associate editor of Journal of Shoulder and Elbow Surgery and editorial board member of Arthroscopy; receives honoraria in the form of lecture fees from Limacorporate and Zimmer Biomet and in the form of manuscript fees from Elsevier, Thieme, Springer, and deGruyter; and receives grant/research funding from SECEC (Société Européenne de Chirurgie de l'Epaule et du Coude), Alwin-Jäger-Stiftung, Forschungsförderung HHU, and Deutsche Arthrosehilfe. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

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“… 10 , 14 The use of CO 2 for knee arthroscopy has been in practice since the 1980s, with some surgeons indicating an advantage over a fluid medium with regard to an improved view due to elimination of floating debris and blood and a more natural appearance of the joint cavity. 1 , 8 , 12 , 17 Options for dry cartilaginous work in the knee include the use of arthroscopy without fluid (dry scope) or CO 2 for insufflation. The majority of the case series related to gas insufflation during arthroscopy are several years old, with incidences of air emboli occurring only when atmospheric air is used in place of CO 2 .…”

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confidence: 99%

Midterm Safety of Carbon Dioxide Insufflation of the Knee During Arthroscopic Cartilage–Based Procedures

Penton¹,

Flick

Savoie

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: When compared with fluid arthroscopy, carbon dioxide (CO2) insufflation offers an increased scope of view and a more natural-appearing joint cavity, and it eliminates floating debris that may obscure the surgeon’s view. Despite the advantages of CO2 insufflation during knee arthroscopy and no reported cases of air emboli, the technique is not widely used because of concerns of hematogenous gas leakage and a lack of case series demonstrating safety. Purpose/Hypothesis: To investigate the safety profile of CO2 insufflation during arthroscopic osteochondral allograft transplantation of the knee and report the midterm clinical outcomes using this technique. We hypothesized that patients undergoing CO2 insufflation of the knee joint would have minimal systemic complications, allowing arthroscopic cartilage work in a dry field. Study Design: Case series; level of evidence, 4. Methods: A retrospective chart review was performed of electronic medical records for patients who underwent arthroscopic osteochondral allograft transplantation of the knee with the use of CO2 insufflation. Included were patients aged 18 to 65 years who underwent knee arthroscopy with CO2 insufflation from January 1, 2015, to January 1, 2021, and who had a minimum follow-up of 24 months. All procedures were performed by a single, fellowship-trained and board-certified sports medicine surgeon. The patients’ electronic medical records were reviewed in their entirety for relevant demographic and clinical outcomes. Results: We evaluated 27 patients (14 women and 13 men) with a mean age of 38 and a mean follow-up of 39.2 months. CO2 insufflation was used in 100% of cases during the placement of the osteochondral allograft. None of the patients sustained any systemic complications, including signs or symptoms of gas embolism or persistent subcutaneous emphysema. Conclusion: The results of this case series suggest CO2 insufflation during knee arthroscopy can be performed safely with minimal systemic complications and provide an alternative environment for treating osteochondral defects requiring a dry field in the knee.

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Arthroscopy and Arthroscopic Surgery in a Gas Versus a Fluid Medium

Cited by 32 publications

References 0 publications

A risk–benefit analysis of alternating low-pressure CO2 insufflation and fluid medium in arthroscopic knee ACL reconstruction

A risk–benefit analysis of alternating low-pressure CO2 insufflation and fluid medium in arthroscopic knee ACL reconstruction

Editorial Commentary: Elbow Arthroscopy in the Pediatric Patient—Small Lesions in a Small Joint but With a Big Impact

Midterm Safety of Carbon Dioxide Insufflation of the Knee During Arthroscopic Cartilage–Based Procedures

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