Burgaard P, Blyme P J, Olsen P M, Kristensen G
Department of Orthopedics T, Gentofte Hospital, University of Copenhagen, Denmark.
Acta Orthop Scand. 1988 Dec;59(6):692-4. doi: 10.3109/17453678809149427.
We used 10 cadaver knees to estimate the safe pressure during arthroscopy by measuring the volumes and pressures of irrigation fluid at different flexion angles. Maximum volumes could be contained at 35 degrees of flexion. Pressures of 200 to 450 mmHg were measured, and all the knees ruptured by extension or flexion after they were filled to 100 mmHg at 35 degrees of flexion. Fifty milliliters of irrigation fluid had to be removed if the pressure remained constant when extending from 35 degrees and 70 ml when flexing to 90 degrees. Totally, 100 ml irrigation fluid had to be removed when flexing from 35 degrees to 120 degrees. Our investigation indicates that a pressure of 150 mmHg can be tolerated by all knees. Both flexion and extension from the 35 degrees position must be done gently and slowly using a large bore, wide-open inflow and outflow tubes allowing egress of irrigation fluid to prevent capsular rupture, extravasation of irrigation fluid, vascular compromise, or compartment syndrome.
我们使用10个尸体膝关节，通过测量不同屈曲角度下冲洗液的体积和压力来估计关节镜检查期间的安全压力。在35度屈曲时可容纳最大体积。测量到的压力为200至450 mmHg，并且所有膝关节在35度屈曲时充至100 mmHg后，通过伸展或屈曲均发生破裂。当从35度伸展时，如果压力保持恒定，必须去除50毫升冲洗液；当屈曲至90度时，需去除70毫升。从35度屈曲至120度时，总共必须去除100毫升冲洗液。我们的研究表明，所有膝关节都能耐受150 mmHg的压力。从35度位置进行屈伸时，必须使用大口径、完全打开的流入和流出管，缓慢轻柔地操作，以使冲洗液流出，防止关节囊破裂、冲洗液外渗、血管损伤或骨筋膜室综合征。
