shavers. If the pump doesn't "talk" and automatically adjust the intra-
articular pressure when the shaver's suction is applied, the walls of the
joint will collapse. Newer pump systems have inflow and outflow can-
nula integrated into shavers, so the pump will increase the flow of fluid
to maintain joint pressure when the instruments are activated.
Setting up older gravity-based pumps is relatively easy; a fluid-filled
bag is hung on a pole and gravity pulls fluid into the joint. The more
pressure you need, the higher you hang the bag. Newer pump systems
involve a slight learning curve with respect to connecting the pump tub-
ing properly and prepping the system between cases, says Dr. Owens.
However, he says, pump manufacturers have designed user-intuitive
platforms to make set-up easier and faster. For example, newer pumps
can be programmed to adjust the flow of fluid based on individual sur-
geon preferences during specific procedures.
High-end pump systems decrease the amount of fluid that's required
to maintain a stable operative field. Instead of constantly pumping
fluid into the joint, they maintain joint pressure with just the right
amount. Less fluid spills out of the joint and into suction canisters or
direct-to-drain fluid management systems, meaning your overall fluid
waste management costs decrease.
Pump systems can often be obtained at no cost in exchange for pur-
chasing the disposable tubing needed for each case, points out Dr.
Owens. He says investing in a state-of-the-art pump is a "no-brainer"
for reducing case times and shaving seconds off of room turnovers.
2. Ultra high-def imaging
Robert Morgan, MD, a sports medicine specialist at OrthoCarolina
Concord (N.C.), says arthroscopy revolutionized joint injury diagnosis
and treatment, and believes we'll look back in 10 years and realize 4K
ultra high-definition imaging had the same game-changing impact.
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