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pushing that large screw through the soft tissue, it's easier on the patient."
All-suture systems are especially useful for shoulder and hip procedures, says
Dr. Dugas. He notes that for cases such as complicated rotator cuff repairs,
where a surgeon may need 12 points of fixation, the small size of all-suture
anchors lets surgeons place the numerous points in the joint more easily.
Plus, compared to bioabsorbable or metal options, these anchors don't react
with the bone, leave behind soft deposits or cysts, or create gaping holes that can
make revision surgery tough, says Dr. Dugas. These pluses can help offset the
increased cost of the systems, which are now offered by most ortho manufactur-
ers. "The benefit with these isn't necessarily speed, and definitely not price, but
rather patient recovery," says Mr. DeConciliis.
Knotless anchors, another new option, may increase your surgeons' speed.
These devices let surgeons fixate soft tissue to bone without the tedious task of
tying suture knots. They are more expensive than other options, says Mr.
DeConciliis, but can be worth it for some facilities. "If every minute saved in the
OR is saving $15 to $20, you could come out on top financially," he says. "We
haven't gone down that route yet, but I can see how it's beneficial."
3. Automated irrigation pumps
A good arthroscopy pump should irrigate the joint with enough saline to keep it
open while minimizing bleeding and unwanted swelling in surrounding soft tis-
sue, says Nady Hamid, MD, a shoulder and elbow orthopedic surgeon with
OrthoCarolina in Charlotte, N.C. While old pump systems relied on gravity to
insufflate the joint with fluid, new systems automate the process using pressure
sensors that create a constant and predictable flow.
"The docs really like the ability to raise the pressure if there's bleeding that's
getting in the way," says Mr. DeConciliis. "I think an automated pump is essen-
tial."
The latest pumps can determine when the outflow of the fluid is changing —
for example, if a burr is in use and using suction — and modify the inflow
