Arthroscopic knee surgery has revolutionized sports medicine over the last couple of decades. Instead of making a long incision to open the knee and repair or remove the injured structures, we can perform most procedures through a few tiny incisions.
Orthopaedic surgeons perform these surgeries more than ever. Arthroscopic knee surgeries have increased 46% between 1996 and 2006.
Arthroscopic partial meniscectomy is the most common orthopaedic operation performed in the United States. In fact, I perform almost all of my knee surgeries arthroscopically.
Is knee arthroscopy a benign surgery?
Many patients believe that the surgeon’s ability to look in the knee with a scope and perform the repair through small incisions decreases the significance of the surgery. However, these are still real surgeries, requiring anesthesia and often lengthy recoveries. How likely are postoperative complications?
A study recently published in the American Journal of Sports Medicine sheds light on surgical complications after knee arthroscopies. Researchers at the University of Pittsburgh Medical Center collected data from 92,565 arthroscopic knee surgeries entered into the American Board of Orthopaedic Surgery database by applicants taking their board exams. They found that complication rates might be higher than we previously believed.
Complications of arthroscopic knee surgery
• Overall, 4.7% of arthroscopic knee surgeries had a postoperative complication.
• The rate of complication varied with the type of procedure. Partial meniscectomy had the lowest complication rate – 2.8%.
• As the complexity of the procedure increased, so did the complication rate. 7.6% of meniscal repairs developed complications, while 9.0% of ACL reconstructions and 20.1% of PCL reconstructions had complications.
• Patients younger than 40 had a much higher complication rate (6.2%) than patients older than 40.
• Surgeries performed by fellowship-trained sports medicine surgeons had higher complication rates than the those performed by non-fellowship trained surgeons (5.1% versus 4.1%).
It is plausible that the complexity of the surgery could explain these last two findings. Younger patients are more likely to undergo ACL reconstruction, PCL reconstruction and meniscal repair surgeries. Likewise, fellowship-trained surgeons might be more inclined to perform more complicated cases.
This study demonstrates that all surgeries, even arthroscopic ones, carry risks of complication. If you are preparing to undergo any knee surgery – partial meniscectomy, meniscal repair, ACL surgery or any other procedure – you need to understand that complications can occur. Healthcare providers can fully explain these procedures and possible risks with the patient ahead of time as well.
Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD. Complications after arthroscopic knee surgery. American Journal of Sports Medicine. Published online ahead of print November 27, 2013.