Dermal Burns Associated With Bipolar Radiofrequency Ablation in the Subacromial Space

Troxell, Corey R.; Morgan, Craig D.; Rajan, S. Sundara; Leitman, Elliot H.; Bartolozzi, Arthur R.

doi:10.1016/j.arthro.2010.10.013

Cited by 20 publications

(14 citation statements)

References 8 publications

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“…6 Several case reports in the shoulder literature have reported second-degree dermal burns after arthroscopy because of skin contact with effluent. 7,8 Described burns were 0.5inch linear streaks oriented according to gravity in the lateral decubitus position. None originated from an arthroscopic portal.…”

Section: Discussionmentioning

confidence: 99%

Dermal Burn During Hip Arthroscopy

Curtin¹,

Friebe²

2014

Orthopedics

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Radiofrequency devices are often used during arthroscopic surgery, most commonly of the shoulder and knee, and increasingly in hip arthroscopy. The most commonly described complication is elevation of joint temperature, leading to capsular shrinkage, chondrolysis, and nerve damage. A less commonly reported complication is that of dermal burns from the heated irrigation fluid. There are several case reports describing dermal burns after shoulder arthroscopy; however, to the authors' knowledge, there are none describing the complication in hip arthroscopy that is often performed by surgeons doing limited if any shoulder arthroscopy. The authors report this case to raise awareness that the use of radiofrequency devices can also lead to extra-articular complications because of the effect of elevated irrigant fluid temperatures on the patient's skin. Sufficiently high temperatures were generated inside the joint, causing a superficial second-degree burn from the outflow irrigant. In the course of instrument switching from sucker/shaver to radiofrequency wand, the outflow valve was inadvertently left open with no attached suction while the radiofrequency wand was in use. Most second-degree burns like the one reported require only conservative therapy with cool compresses to decrease the temperature of the wound. The authors did recommend bacitracin ointment to prevent superficial wound infection, however unlikely with no disruption of the skin. The authors continue to use radio-frequency devices in hip arthroscopy, but are vigilant to maintain dedicated suction at the outflow tubing throughout the procedure. Surgeons should take strict precautions to avoid this preventable complication and follow all manufacturer instructions on the use of such devices.

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Section: Discussionmentioning

confidence: 99%

Dermal Burn During Hip Arthroscopy

Curtin¹,

Friebe²

2014

Orthopedics

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“…Caution should be used when extensively using an RF device during arthroscopic shoulder surgery, because heated effluent may result in skin burns. 17,18 This risk may be minimized by ensuring adequate flow rate across the joint. 19 The main disadvantage of our technique is the amount of flexibility in the shaft of the flexible RF ablator probe.…”

Section: Discussionmentioning

confidence: 99%

Use of a Hip Arthroscopy Flexible Radiofrequency Device for Capsular Release in Frozen Shoulder

Thompson

LeBel

2012

Arthroscopy Techniques

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Adhesive capsulitis is a common and challenging condition to treat. Arthroscopic capsular release is usually contemplated when conservative treatment fails or when there is severe and/or chronic loss of range of motion. This procedure can be difficult to perform because of difficult access to the joint, poor visualization, and loss of working space from retraction of the joint capsule. The articular surfaces and the axillary nerve are also at higher risk of injury. Arthroscopic scissors, shavers, and electrocautery are typically used to perform the capsular release. To perform a safer and more precise arthroscopic shoulder capsular release, a creative and innovative use of a flexible hip arthroscopy radiofrequency ablator is described.

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“…70 ) closed outflow suction system to the radiofrequency device. 74 Acute shoulder chondrolysis after arthroscopic rotator cuff repairs has also been attributed to continuous infusion of intra-articular anesthetics. A systematic review found that nearly 60% of reported postarthroscopy chondrolysis cases were associated with the use of intra-articular infusion of either bupivacaine or lidocaine.…”

Section: Complicationsmentioning

confidence: 99%