BACKGROUND
Arthroscopic knee washout is employed to clear infection either in the native joint or following arthroplasty. Irrigation fluid is introduced into the joint using an arthroscopic port. Common practice involves occluding the end of this port with a gloved thumb to allow fluid to collect within the joint before being flushed away. This method results in spillage of saline and inadequate pressure build up. We describe a simple technique to avoid these problems.
TECHNIQUE
The patient is prepared and draped in the usual way. An antero-lateral portal is established, the blunt trocar is removed and the saline tubing connected. A 10-ml syringe is dismantled and the plunger section inserted into the end of the arthroscopy port (Figs 1 and 2). The syringe tube may be discarded. The saline is then switched on and allowed to wash through the knee joint and out via a second port in standard fashion.
Figure 1.
Arthroscopy port with irrigation attached and syringe end to one side.
Figure 2.
End of syringe used to block port.
DISCUSSION
This technique creates a water-tight seal around the end of the arthroscopy port to ensure that no irrigation fluid is lost as back-flow out of the port. This allows the surgeon to concentrate on adequate washout of the entire joint. It also enables accurate assessment of the volume of fluid used and minimises saline spillage onto the floor of the operating theatre. This is a useful technique which helps to simplify the procedure and also improves theatre safety.