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A U G U S T 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
may also be improved. Consider, for example, the traditional method of repair-
ing a torn rotator cuff. We'd have to make a sizable skin incision, detach the del-
toid muscle, reach the depth of the injury, chisel down the bone spur, manually
sew up the tear, then repair the deltoid we'd detached before closing the inci-
sion. Arthroscopically we can perform the same repair just as well or better
without causing such tissue trauma in the process. The same goes for replacing
torn anterior cruciate ligaments with grafts, or other joint procedures that used
to require extensive exposure.
Fixation and fluid flow
The bone-and-tissue repairs of joint surgery demand a mechanism by which
tissue can be fixed to bone. High-strength suture is often the solution, but
tying a reliable, stable knot through the straw's-width of an arthroscopic
access port can prove challenging.
In recent years, we've seen the introduction of a wide variety of knot-tying
devices and insertable, pre-tied implant systems for rotator cuff and meniscus
repairs. One particularly advanced technolo-
gy lets surgeons tighten up noose-like
sutures that have already been tied. Such
innovations stand to make surgery more effi-
cient and help surgeons to deliver more
reproducible results.
Joints are essentially collapsed spaces.
Fluid irrigation is necessary to keep the
joint space open in order to insert scopes to
visualize anatomy and instruments to treat
injuries. A continual, consistent flow of
saline solution ensures that the fluid
remains clean enough to see through and
the pressure remains high enough to keep
M I N I M A L L Y I N V A S I V E S U R G E R Y
OVERALL OUTCOME The ultimate
measure of surgical innovation is
its impact on patient care.
