Intra-Articular Steroids After Arthroscopy for Osteoarthritis of the Knee

Gosal, H. S.; Jackson, Allen; Bickerstaff, D. R.

doi:10.1302/0301-620x.81b6.0810952

Cited by 11 publications

(5 citation statements)

References 25 publications

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“…Marmor et al [21] reported a paradoxically higher proportion of lawsuits for septic arthritis after arthroscopy (42%) than after arthroplasty (27%) after analysis of insurance data. The authors identified several risk factors such as irrelevant indications (especially diagnostic arthroscopy) and also the use of intraoperative corticosteroids, which they advise against [6, 15]. Although 2 cases of septic arthritis after corticosteroid injection during an arthroscopy were observed in our series of cases, there were 13 cases of septic arthritis after diagnostic arthroscopy or arthroscopic lavage.…”

Section: Discussionmentioning

confidence: 95%

Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France

Pioger

Jacquet

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose The main objective of this study was to identify the epidemiological characteristics of litigation following arthro-scopic procedures, performed in private practice and public hospitals in France. The secondary objective was to establish a risk profile for medical malpractice lawsuits after arthroscopic surgery. Methods All court decisions related to arthroscopic surgery between 1994 and 2020 were collected and reviewed cases from the two main French legal databases (Legifrance and Doctrine). Data were retrospectively collected and included: gender, joint and defendant's specialty involved, reason behind the lawsuit, initial indication and the type of arthroscopic procedure performed. The final verdicts as well as the indemnity awarded to the plaintiff (if any) were recorded. Results One-hundred eighty cases met the inclusion criteria of the study and were analyzed: 58 cases were before administrative courts and 122 were before civil courts. An orthopaedic surgeon was involved alone or in solidum in 45.6% of cases (82/180), followed by anesthesiologists in 5.6% (10/180). The private surgery center or public hospital were implicated in 63.9% (115/180) of cases. The 2 most common joints involved in litigation following arthroscopic surgery were the knee (82.2%, n = 148) and the shoulder (11.1%, n = 20). The main reasons behind the lawsuit were related to postoperative infection in 78/180 cases and to a musculoskeletal complication in 45/180 cases (25%). A failure to inform was also reported in 34/180 cases (18.9%). Of the 180 cases, 122 cases (67.8%) resulted in a verdict for the plaintiff. The average indemnity award for the plaintiff was 77.984 euros [2. 282-1.117.667]. A verdict for the plaintiff was significantly associated with postoperative infection or a wrong-side surgery, while technical error and musculoskeletal complications were more significantly likely to result in a verdict in favor of the defendant (p = 0.003). Conclusion This study evaluated and mapped lawsuits following after arthroscopic surgery in France over a period of more than 20 years. The main joint involved in lawsuits was knee. The main causes of lawsuits following arthroscopic surgery were related to postoperative infection, musculoskeletal complications and failure to inform. Level of Evidence Level IV.

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Section: Discussionmentioning

confidence: 95%

Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France

Pioger

Jacquet

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…There is almost certainly impairment of local and systemic immune defence mechanisms. 38,39 Prophylactic antibiotics are not routinely used for arthroscopic surgery, apart from more complex procedures such as reconstruction of the ACL. D' Angelo and Ogilvie-Harris, 37 however, have suggested that there may be a case for their use from the point of view of cost benefit.…”

Section: Resultsmentioning

confidence: 99%

Complications of arthroscopic meniscectomy in the hands of third world beginners

Muzaffar¹,

Shah²

2013

OA Orthopaedics

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“…There is experimental evidence to suggest an increased risk of infection after the intra-articular administration of steroids. [15][16][17] Our study has the inherent limitations of any retrospective review. It is relatively small, but does allow us to conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for TKR should not be taken lightly.…”

Section: Discussionmentioning

confidence: 99%

Infection in knee replacements after previous injection of intra-articular steroid

Papavasiliou

Isaac

Marimuthu

et al. 2006

The Journal of Bone and Joint Surgery. British volume

125

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We reviewed 231 patients who had undergone total knee replacement with an AGC (Biomet) implant over a period of 2.5 years. After applying exclusion criteria and with some loss to follow-up, there were 144 patients available for study. These were divided into two groups; those who had received intra-articular steroid in the 11 months before surgery and those who had not. There were three deep infections, all of which occurred in patients who had received a steroid injection. The incidence of superficial infection was not significantly different in the two groups. Five patients had undergone investigation for suspected deep infection because of persistent swelling or pain and all of these had received an intra-articular injection pre-operatively. We conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for total knee replacement should not be taken lightly because of a risk of post-operative deep infection.

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Intra-Articular Steroids After Arthroscopy for Osteoarthritis of the Knee

Cited by 11 publications

References 25 publications

Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France

Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France

Complications of arthroscopic meniscectomy in the hands of third world beginners

Infection in knee replacements after previous injection of intra-articular steroid

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