Tears of the Manica Flexoria Treated by Tenoscopic Surgery

Electrosurgery - background
Electrosurgical devices consist of a transformer, an oscillating circuit, a treatment electrode and a ground plate. When the patient is added an electric circuit is established and the electrical energy serves to coagulate or cut. The current enters the handheld electrode, flows through the patient through the path of least resistance (blood vessels), to the ground plate (Monopolar devices). The electrode itself does not become hot but causes the tissue to heat from the inside. Four factors influence the degree to which a tissue is damaged: surface area of the treatment electrode; tissue contact time; power setting and the type of current (damped, rectified or filtered).

Monopolar electrosurgery should ideally be used in a non-conductive medium during arthroscopy/tenoscopy. As normal saline and Ringer’s lactate are electrolyte solutions, they could potentially conduct the current to other parts of the body and reduce the efficiency of the local electrical action. 1.5% glycine is therefore recommended as a non-conductive solution for lavage during arthroscopic electrosurgery as least changes in cartilage were observed when it was compared to other solutions (water, normal saline and 2.6% glycerol). When the electrosurgical procedure is completed the joint/sheath is then lavaged with an isotonic polyionic solution.

There are a variety of electrosurgical electrodes available but hook and loop electrodes are the most useful for these procedures. They are disposable, 165 mm in length and insulated to the tip with plastic. They may be used several times to reduce costs, though not recommanded by the manuscfacturer.  [...]