Explanation
Prolonged use of high-pressure fluid pumps, especially without adequate outflow, can lead to severe fluid extravasation into the surrounding soft tissues. In shoulder arthroscopy, this can cause massive soft tissue swelling, potentially leading to compartment syndrome of the upper extremity or, more critically, life-threatening airway compromise if the fluid tracks medially into the neck. While air embolism is a risk with atmospheric exposure, and chondrolysis is a risk with certain pain pumps (bupivacaine), fluid extravasation is the direct mechanical risk of high-pressure irrigation. Reference: Miller's Review of Orthopaedics, 8th Edition.