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geries. While the knee is encapsulated and does not experience as much
swelling as a result of fluid flow, the shoulder's anatomy is different, and
the risk of painful swelling and complications increases over time.
Assessing the advances
A lot of technological tweaks have been introduced into arthroscopic surgery,
which promise previously unattainable techniques or efficiency. Some are help-
ful developments, while others are flashes in the pan. Does efficiency equate to
better outcomes? Not always. One of the things we surgeons and administrators
struggle with is determining which are true advances for the field.
The key to adopting new technology — in other words, approving the pur-
chase of new equipment — is assessing the available options as a team. The
expensive scope system may be great for the surgeon, but a burden on the facili-
ty's budget. The inexpensive one might be more manageable on the bottom line,
but it may affect the quality of surgical visualization. And which one's compo-
nents will the sterile processing department be able to turn around in time to
keep up with the daily OR schedule? Taking a team approach can get views
from all angles.
Above all, though, find out what you can about the technology through the
available research and scientific data. Are its best outcomes reproducible?
All surgical devices ultimately are judged by the roles they play in facilitating
successful patient outcomes.
OSM
Dr. Connor (
pa trick .connor@orthoca rolina .com
) is an orthopedic surgeon at
OrthoCarolina's Sports Medicine Center and Shoulder and Elbow Center in Charlotte,
N.C.
M I N I M A L L Y I N V A S I V E S U R G E R Y
