Evaluation Background: Arthroscopic Irrigation/Distention Systems

Here's background for our Evaluations of arthroscopic irrigation/distention systems (AI/DSs), outlining the key considerations for making wise purchasing decisions. Learn how the technology is used, which specs are important, and what factors we test for. Also review our latest product ratings and ECRI Institute's data describing hospitals' interest in each vendor.

AI/DSs are used during arthroscopic procedures to expand the natural joint space with clear, pressurized solution such as Ringer's solution or normal saline. Distention of the joint enlarges the operative space and improves visibility. It also keeps the joint clear of debris and produces a tamponade effect, controlling small-vessel bleeding within the joint, thus often precluding the need for a pneumatic tourniquet. This reduction in bleeding also improves visibility.

To be considered in this technology category, a device should be able to maintain joint pressure in the range of 20 to 100 mm Hg at flows up to ≥500 mL/min. It should also facilitate momentary increases in pressure or flow. The major components of the AI/DSs we evaluated are a pump to infuse solution into a joint to maintain a procedure-specific pressure, a pump for removing solution from the joint and automating control of flow, and a footswitch and/or remote control for briefly increasing pressure or flow.

AI/DSs are used for arthroscopic procedures on knees, shoulders, hips, and smaller joints including wrists and elbows. AI/DS technology is mature, although units typically do not have an overpressure-relief mechanism, a feature that ECRI Institute recommends.

AI/DSs are used in hospital and ambulatory surgery center ORs. They are used by orthopedic surgeons. These devices are referred to by a number of names; common synonyms include arthroscopic pumps and fluid management systems.

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