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accordingly to maintain pressure. Not only does this make the process more
efficient, says Dr. Hamid, but it also can reduce the total amount of fluid used.
This helps prevent swelling — important in shoulder cases — and may even
speed up turnover times.
"We use fluid-preserving pumps now, so you don't have to infuse as much into
the joint," he says. "During previous cases with older pumps, I would go through
10 bags of fluid. Now I only go through 4."
Though pumps have been improved, Dr. Dugas notes that many manufactur-
ers are still working on fixing common pump problems, including clogged tub-
ing and pressure sensor malfunctions, and will likely release new options in
the near future. "If there's room for innovation in arthroscopy it's here," he
says. "Pumps are a couple of generations behind video technology."
4. Biologics for better recoveries
The technology generating the most buzz in orthopedics, however, is biologics,
says Dr. Dugas. Injecting platelet-rich plasma (PRP) and stem cells during sur-
gery may help patients grow healthy cartilage following arthroscopy. The pricey
procedure is becoming especially prevalent in surgical centers, notes Dr. Dugas.
PRP has been around longer than stem cells, says Dr. Safran. While some
surgeons inject it during procedures such as ACL and rotator cuff repairs, it
has shown more promise as an office-based treatment for chronic tendinopa-
thy. Instead, PRP has taken a back seat to stem cell injections, which may has-
ten patient recovery and ward off repeat injuries.
At Dr. Dugas's center, surgeons use a special kit to remove a small amount of
bone marrow from the patient at the start of the arthroscopic procedure. The
marrow is spun in a centrifuge to separate the stem cells while the surgeon
operates. At the end of the procedure, the doctor injects the stem cell concen-
tration into the surgical site to help with recovery. "We've seen significantly
improved results with our patients so far," says Dr. Dugas.
