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Study showed low incidence of complications after ACL reconstruction
When combined, smoking, dyspnea and other risk factors accounted for 3% of complication rate variance.
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In the early postoperative period, ACL reconstruction had a low incidence of complications. The most common of these were symptomatic venous thromboembolic disease requiring treatment, return to the OR and infections, according to study results.
“We looked at a large number of patients who underwent ACL reconstruction from the American College of Surgeons NSQIP database, and we looked at the rate of postoperative complications in the 30 days after surgery [and] found there was an overall 1.3% rate of complications. The most common ones were deep venous thrombosis, return to the operating room and infection; but overall, a low rate of complications,” Gregory L. Cvetanovich, MD, orthopedic surgery resident at Rush University Medical Center, told Orthopedics Today.
Complication rate
Cvetanovich and his colleagues identified postoperative complications in the 30-day period after ACL reconstruction in 4,933 patients. Using univariate and multivariate analyses, researchers analyzed potential patient and surgical risk factors for 30-day complications after ACL reconstruction.
Results showed overall complications occurred in 66 patients, with 27 patients experiencing major complications and 43 patients experiencing minor complications. Symptomatic deep venous thrombosis requiring treatment, return to the OR, superficial infections, deep infections and pulmonary embolism were the most common complications. Overall, a single mortality occurred.
According to results of multivariate analyses, risk factors for the development of overall complications included smoking, dyspnea, a history of chronic obstructive pulmonary disease and recent weight loss. However, researchers found these factors combined accounted for 3% of the variance in the complication rate.
“These are the complications that we worry about in normal practice and a lot of our doctors will prescribe aspirin to help reduce the risk of blood clots, and antibiotics are standard for prophylaxis against infection,” Cvetanovich said. “So these are the normal kind of complications that we worry about, but it helps to quantify them so that we can tell our patients just what their chances are of running into these.”
Long-term risks
Cvetanovich noted two major limitations in their study included the short-term follow-up and not knowing whether certain orthopedic variables, such as type of graft, affected the risk of clinical complications.
“The next step would be attempting to look at different sources of patients, whether it is our own patients here at Rush or whether different databases would let us answer those questions about longer term risks, as well as whether the variables that are not included in this database impact the patient complications,” Cvetanovich said. – by Casey Tingle
- Reference:
- Cvetanovich GL, et al. Am J Sports Med. 2016;doi:10.1177/0363546515622414.
- For more information:
- Gregory L. Cvetanovich, MD, can be reached at the Division of Sports Medicine, Rush University Medical Center, 1611 West Harrison St., Suite 300, Chicago, IL 60612; email: gregory.cvetanovich@gmail.com.
Disclosure: Cvetanovich reports no relevant financial disclosures.