Reusing high-value consumables in shoulder arthroscopy: feasibility and overlooked complications

Background In many countries, disposable high-value consumables are sterilized and reused for economic reasons. We aimed to study the feasibility and ways to reduce potential risks of reusing these consumables in shoulder arthroscopy. Methods We reported cases with complications potentially related to reusing high-value consumables. We evaluated the outflow water temperature from new and reused radiofrequency (RF) devices of different brands and under varying surgical practices. We also conducted fatigue tests on suture-passing needles from different brands subjected to various disinfection methods. Results Reused RF devices from MECHAN demonstrated significantly higher peak temperature (PT) (68.3 ± 2.3°C vs 63.9 ± 3.0°C, P < 0.001) and peak sustaining temperature (PST) (62.6 ± 2.3°C vs 58.5 ± 3.1°C, P < 0.001) compared to new devices. The mean flow rate of MECHAN devices was higher than that of DePuy (63.2 ± 8.2 ml/min vs 42.0 ± 11.1 ml/min, P < 0.001). Ethylene oxide disinfection did not significantly affect the excitation times before fatigue fracture of Arthrex (291.6 ± 76.9 vs 305.1 ± 86.6, P = 0.717) and DePuy (173.3 ± 26.8 vs 174.6 ± 31.7, P = 0.922) suture-passing needles. High-pressure steam disinfection also did not markedly affect the fatigue time of Arthrex (291.6 ± 76.9 vs 292.0 ± 65.7, P = 0.990) and DePuy (173.3 ± 26.8 vs 168.8 ± 36.1, P = 0.755) suture-passing needles. Conclusions For both RF devices and suture-passing needles, being reused after ethylene oxide disinfection for appropriate times can be feasible and safe if surgeons and disinfection suppliers exercise caution.