Ankle and shoulder arthroscopy equipment: what the OR needs

Common tower and what changes by joint

All arthroscopy uses a camera, light source, scope, monitor and a fluid system, with shavers or radiofrequency devices for tissue work. The tower is the same for knee, shoulder, ankle and small joints, so choosing a versatile camera and pump pays off. Our article on the arthroscopy equipment list covers the general set, and knee arthroscopy instruments gives the reference case.

What changes between joints is the scope diameter, the instruments, the positioning and the way pressure and flow are managed.

Shoulder arthroscopy equipment

Shoulder work is usually done in the beach-chair or lateral decubitus position. The set-up therefore needs a table or chair with suitable attachments, an arm positioner or traction device and enough space for the tower on the correct side. The scope is commonly a 4 mm, 30° arthroscope; a 70° scope is used less often for particular views.

Pump pressure, flow and outflow are important in the shoulder because soft-tissue swelling can limit visibility. Equipment teams should check the pressure range, flow and automatic control of the pump. Richard Wolf's FLUID CONTROL 2225 is documented for irrigation and suction in gynaecology, urology and general surgery, with maximum irrigation flow of 1800 ml/min and suction flow of 2000 ml/min. For arthroscopic use, confirm pump suitability and settings directly with the supplier; see also the arthroscopy pump guide.

Ankle arthroscopy equipment and small-joint scopes

Ankle arthroscopy equipment is designed around limited space. A 2.7 mm scope is a common choice for the ankle and other small joints such as the wrist or elbow, and a 4 mm scope may be used where space permits. A 30° view is standard; a 70° scope may help in some corners of the joint. Small instruments, small shavers and gentle fluid settings protect the cartilage.

For ankle work, many surgeons use non-invasive or invasive distraction to open the joint and a leg holder or well-leg support. Choose supports that are radiolucent if the surgeon uses fluoroscopy. A short arthroscope with a smaller light post may be needed for narrow joints, so confirm the light-cable fit.

• Scope sizes: 2.7 mm for small joints, 4 mm for the shoulder and larger joints.
• Angles: 30° as the standard, 70° as an option for special views.
• Cameras: compact heads that are balanced on thin scopes.
• Sterilization: confirm autoclave compatibility for scopes and camera heads.

Fluid management and recording

Arthroscopy depends on controlled irrigation. A pump with pressure feedback keeps the joint distended without extravasation, and tubing sets must match the pump. The fluid management systems article describes sensors, deficits and safety alarms.

For documentation, a camera that records stills and video to USB is useful. The ENDOCAM Logic HD from Richard Wolf, for example, records Full HD video to USB with still-image memory, and the 4K version offers image and video storage to USB.

Specifying a set and getting help

Define the joints and annual volume, then specify scopes by diameter and angle, number of spare scopes, shaver or radiofrequency system, pump, supports and sterilization trays. Verify device registration with the relevant UAE authority and ask for service terms.

Beckfinity can advise on Richard Wolf imaging and fluid equipment for orthopaedic use. Browse the Richard Wolf brand page or contact our team via the contact page.