Preventing damage to arthroscopic lens during surgery.

摘要

PURPOSE: To evaluate the relation between the relative diameter of instrument tips and the distance between the arthroscopic lens and the tips of the instruments in terms of preventing lens damage during arthroscopy. METHODS: By use of a custom-designed station device with 2 perpendicular portals, images of multiple-sized shaver tips (2.5, 3.5, 4.0, 5.0, and 5.5 mm) were obtained from 4 different arthroscopes (4 mm 30 degrees , 4 mm 70 degrees , 2.7 mm 30 degrees , and 2.7 mm 70 degrees ) at varying distances of 0 to 10 mm at 1-mm increments. The relative diameter of the visualized instrument tips and the distance between the arthroscopic lens and the tips of the instruments were evaluated. RESULTS: The relative diameter of the shaver tips measured by 2 investigators showed excellent intraobserver and interobserver reliability. By use of 2 mm as the safe distance from the arthroscopic lens to the tip of the shaver, 13 of 14 arthroscopic lens-shaver combinations were considered safe when the visualized shaver tip was smaller than one-half of the arthroscopic visual field. Six of 14 combinations were considered unsafe when the visualized shaver tip was larger than three-fourths of the visual field. CONCLUSIONS: In this experimental study, the safe distance of 2 mm could be maintained when arthroscopic instruments used during surgery (e.g., shavers and burrs) were observed to be less than one-half of the arthroscopic visual field. The relative diameter of the visualized instrument tip was a reliable guide to prevent arthroscopic lens damage. CLINICAL RELEVANCE: To avoid damaging the arthroscope lens during surgery, arthroscopists can maintain a safe distance by keeping the relative diameter of the instrument tip (e.g., arthroscopic burr) to less than one-half of the arthroscopic visual field.