Arthroscopic irrigation/distention systems.

Arthroscopic irrigation/distention systems (AI/DSs) are used during endoscopic orthopedic procedures to keep the cavity of a joint (such as the knee or shoulder) filled with pressurized distention solution. This expands the joint, thereby improving visualization. Controlled release of this solution from the joint is used to flush out debris. For this study, we evaluated units that use a motorized pump to propel fluid into the joint. We based our judgment primarily on how well the units sustained safe pressures inside the joint. We tested seven units from six suppliers, finding three of them Acceptable: the Karl Storz Arthropump 283300 20, the Richard Wolf Arthro Pump 2202, and the W.O.M. Arthro-Surgimat. We found a fourth unit Conditionally Acceptable: the Linvatec APEX Universal C7100A. We recommend against purchasing any of the other three units because of problems or limitations in their performance. In addition to our testing and results, this Evaluation includes an overview of AI/DS technology. We also discuss how AI/DSs can contribute to extravasation of distention solution into a joint and note the pressure levels that are considered safe. In addition, we outline the primary factors a facility should consider when selecting an AI/DS--including whether a pump-type AI/DS is the best choice for every facility.