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Tools to Improve Your Arthroscopy Service
Faster turnaround and better outcomes are within reach.
Jim Burger
Publish Date: January 7, 2015   |  Tags:   Orthopedics
tools for surgeons SATISFIED CUSTOMERS When surgeons have the best tools for the job, efficiency and safety follow.

Keep your orthopedic surgeons happy and you'll not only keep your arthroscopy service line humming, you'll likely keep everyone else happier, too. You may not be able to predict all of your surgeons' preferences, but there's a good chance these offerings will appeal to just about everyone.

  • Arthrex SynergyHD3 Camera System
    HD cameras, LED lighting and image management are integrated into one console and individual surgeon preferences can be programmed into the system. There's also a remote tablet interface that can be draped in an x-ray cassette cover and used in the sterile field. "The biggest advance in arthroscopy is that ability to have everything in one console," says Greg DeConciliis, PA-C, CASC, administrator of Boston Out-Patient Surgical Suites in Waltham, Mass. "The camera, the light source — you don't have to have 3 separate boxes anymore. You can actually annotate things throughout the case and record what's being done." The surgery can also be transmitted to an iPad or other device and watched in real time.

    "And after everything is finished, it can be e-mailed to the patient, to the doctor's office or incorporated right into the EMR," says Mr. DeConciliis. The technology isn't cheap, but the savings is real, he says: "When we trialed various options, that ability was what kept them in the game. We spend so much on paper and ink — to be able to just e-mail pictures is great. If we don't have to print anymore, that's a huge savings."

  • Dornoch (Zimmer) Fluid Management Systems
    When the Stryker Neptune was recalled a couple of years ago, a lot of facilities found themselves scrambling to find an alternative. "We really, really liked Neptune and were like, 'Oh man, we don't want to go back to canisters,'" says Teresa A. Nosek, RN, BSN, CNOR, ONC, orthopaedic specialty coordinator at Community Surgery Center North in Indianapolis, Ind., recoiling at the memory of her staff having to dump 5 or 6 canisters after every case. "But we did some research and we found Dornoch."

    The Neptune's back, of course, but Ms. Nosek sees no reason to change. "It's very similar to the Neptune. We just change the filter in between patients, so we're not dumping canisters. That really helps with turnover. And we got such a great deal, there's no need to go back."

  • Arthrex Passport Cannulas
    If you've seen enough surgeries, chances are you've seen a cannula shoot out of a patient when pressure was adjusted, the soft tissue holding it became overly stretched or an instrument was taken out of the cannula. This device has what the company calls "low-profile flanges" that create a more stable portal and reduce the likelihood of cannula loss. "This provides for continuous pressure within the joint and, most importantly, allows the surgery to progress without interruption," says Mr. DeConciliis.
  • Knotless anchors
    Tying knots can be challenging and time-consuming for some surgeons. There's no need with these fixation devices, which provide strong, stiff repairs without the need to tie knots. "Knotless devices are a little more expensive," says Mr. DeConciliis, "but they're very, very quick, which saves OR time. They're really very cutting edge." Most sports medicine device companies make them. All-suture anchors have also become more prevalent recently. "By replacing the metal, PEEK or bioabsorbable anchor with suture, there's less bone removal for the implant placement, with equal or better fixation strength," says Mr. DeConciliis.
  • Arthrex DualWave Arthroscopy Pump
    Durable and versatile, the DualWave works with every shaver system on the market and has a continuous pulse-free flow that responds to changes in joint distention under the highest shaver suction settings.

    "We use it for hips, knees, shoulders, wrists ankles and elbows," says Ms. Nosek, "and not one of my 15 surgeons complains."

    Another brand had a design flaw, she says, involving a cartridge that frequently ended up with fingerprints or dents. "We were constantly replacing that part of the pump," she says. "Now we don't have to worry about that."
    Nor do they worry about compatibility issues. "One surgeon uses a Smith & Nephew Dyonics cannula as his inflow cannula," she says. "We just put an adapter on for him."

  • Ambient ArthroWand from ArthroCare
    How do you know if the water going through the joint is hotter than it should be?
    By using a device like this one, which provides real-time temperature monitoring of circulating fluid to ensure the temperature within the joint is being maintained at a safe level. Surgeons can set both visual and audio alarms that alert them when the temperature reaches a certain point. "That's helpful and gives you comfort knowing you're ensuring patients' safety," says Mr. DeConciliis.
  • Truepass Suture Passer from Smith & Nephew
    Several companies are on board with step-saving suture-passing devices, which allow for one-handed control and simultaneous suture passing and retrieval. But Truepass "is a lot easier to manage," says Ms. Nosek. "Sutures don't get tangled up the way they do with other systems."
  • Levelert II Fluid Level Sensor from Smith & Nephew
    A simple solution to a chronic problem, this device warns the OR staff when irrigation fluid bag levels are getting low. "It's one of those things," says Mr. DeConciliis. "Inevitably, the water runs out during surgery at the most inopportune times. The surgeon gets upset and it disrupts the flow of the procedure."

    The answer: Hang the sensor on your IV pole and the fluid bag on the sensor. When the level diminishes to a pre-determined level, the device sounds a warning and bags can be swiftly switched out.

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