This article is more than 5 years old. Information may no longer be current.
Minor complications more common in young patients after knee arthroscopy
Minor complications are more common than major complications among children and adolescents after knee arthroscopy, according to study results.
Researchers retrospectively reviewed 1,002 knee arthroscopies performed among patients 17 years old or younger from 1997 to 2009. The researchers collected patient demographic and surgical data from medical and surgical records with specific focus on intraoperative and postoperative complications.
Study results showed an overall complication rate of 14.7%, with major complications occurring in 2.1% of surgeries and minor complications occurring in 12.6% of surgeries.
Major complications included septic arthritis, wound complication requiring operative revision, arthrofibrosis requiring manipulation, other unplanned subsequent surgery and death, whereas minor complications included persistent effusion/hemarthrosis requiring arthrocentesis and superficial wound infection.
The researchers found statistically significant increases in the risks for major complications in surgeries with an anesthesia time of 265 minutes or greater, operative time of 220 minutes or greater, or tourniquet time of 114 minutes or greater, as well as in surgeries with three or more Current Procedural Terminology codes.
Disclosure: The authors have no relevant financial disclosures.
Perspective
Back to TopThe authors should be commended for reporting their complications in 1,002 young patients undergoing knee arthroscopy at a tertiary care center. In this study they found a major complication rate of 2.1% and a minor complication rate of 12.6%, for an overall complication rate of 14.3%. While their major complication rate was similar to other studies involving adult patients, their overall rate is higher. This may be related to their strict inclusion criteria and the complexity of the procedures performed as reflected in their mean surgical time (134 minutes). The fact that anesthesia time was > 265 minutes, tourniquet time > 114 minutes, and procedures with > 3 CPT codes, all surrogate markers for case complexity, had a statistically higher rate of major complications is not surprising.
With the increased level of sports participation in children and adolescents the incidence and severity of knee injuries has also increased. Advances in knee arthroscopic techniques and instrumentation allow for a greater number of complex procedures to be performed in this fashion. Patients and families need to be educated that procedures such as ligament reconstruction and/or meniscal repair, despite the small skin incisions, are complicated and have significant risks associated with them. Surgeons involved with teaching need to be aware of the risks of prolonged anesthesia/surgical time and plan their educational time accordingly.