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Conventional diathermy in arthroscopic anterior cruciate ligament reconstruction - a safe and cost-effective alternative to commercial thermal devices.

During arthroscopic anterior cruciate ligament (ACL) reconstruction, removal of soft tissue is essential in clearing the remnant of the ruptured ACL and defining the posterolateral wall of the femoral notch. Removing soft tissue using diathermy devices as compared to a motorised shaver minimises bleeding. There are several commercially available, single-use, monopolar diathermy systems, the price of which varies from tens to hundreds of pounds. 
 
We use a 5-mm ball-end monopolar diathermy probe (Trewais Surgical Instruments Pty Ltd, Victoria, Australia) for soft tissue removal (Fig. 1). This is run on a conventional diathermy source, using the coagulation mode set at maximum. This probe is reusable, costing about £40. Due to its curvature and low profile, this probe allows precise soft tissue removal. When using this device, sterile water rather than normal saline is used for irrigation. We have used the above probe in hundreds of ACL reconstructions without any adverse effects. 
 
 
 
Figure 1 
 
The 5-mm ball-end monopolar diathermy probe