Do Arthroscopic Fluid Pumps Display True Surgical Site Pressure During Hip Arthroscopy?

Arthroscopy. 2018 Jan;34(1):126-132. doi: 10.1016/j.arthro.2017.08.290. Epub 2017 Nov 2.

Abstract

Purpose: To report on the accuracy of 5 commercially available arthroscopic fluid pumps to measure fluid pressure at the surgical site during hip arthroscopy.

Methods: Patients undergoing hip arthroscopy for femoroacetabular impingement were block randomized to the use of 1 of 5 arthroscopic fluid pumps. A spinal needle inserted into the operative field was used to measure surgical site pressure. Displayed pump pressures and surgical site pressures were recorded at 30-second intervals for the duration of the case. Mean differences between displayed pump pressures and surgical site pressures were obtained for each pump group.

Results: Of the 5 pumps studied, 3 (Crossflow, 24K, and Continuous Wave III) reflected the operative field fluid pressure within 11 mm Hg of the pressure readout. In contrast, 2 of the 5 pumps (Double Pump RF and FMS/DUO+) showed a difference of greater than 59 mm Hg between the operative field fluid pressure and the pressure readout.

Conclusions: Joint-calibrated pumps more closely reflect true surgical site pressure than gravity-equivalent pumps. With a basic understanding of pump design, either type of pump can be used safely and efficiently. The risk of unfamiliarity with these differences is, on one end, the possibility of pump underperformance and, on the other, potentially dangerously high operating pressures.

Level of evidence: Level II, prospective block-randomized study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / methods*
  • Arthroscopy / methods*
  • Female
  • Femoracetabular Impingement / surgery*
  • Hip Joint / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pressure
  • Prospective Studies
  • Young Adult