Since its initial description, 1 wrist arthroscopy (WA) has been increasingly performed, and is now a routine procedure for surgeons dealing with the wrist, not only for diagnosis but mainly for the treatment of pathologies of the wrist. It is usually regarded as a safe procedure. Complications have been reported in the literature as rare (1.2-7.9%) and are mostly minor.2-9 Only 0.9 to 1.1% of the cases are reported as "serious" complications. 7,9 Reports from the literature involve mostly personal series 3-9 with numbers of WA ranging from 84 to 463. There is only one systematic review of the literature, including 895 WA procedures, with a 4.7% complication rate.
2There is currently no large-scale multicenter study of complications published in the literature. The primary purpose of this study was to evaluate the incidence and nature of complications, based on a very large number of patients recruited via a retrospective multicenter study. The second purpose was to investigate about a potential learning curve, as this study includes both experienced and Keywords ► wrist arthroscopy ► complications ► large multicenter review ► learning curve
AbstractBackground Wrist arthroscopy is now a routine procedure, regarded as safe. Complications are reported in the literature as being rare and mostly minor. Purpose The two goals of this study were to evaluate the incidence and nature of complications based on a very large multicenter retrospective study, and to investigate about a potential learning curve. Methods The authors sent a detailed questionnaire to all members of the European Wrist Arthroscopy Society (EWAS), inquiring about the number and types of complications encountered during their practice of wrist arthroscopy, and about their experience with the technique. Results A total of 36 series comprising 10,107 wrist arthroscopies were included in the study. There were 605 complications (5.98% of the cases), of which 5.07% were listed as serious and 0.91% as minor. The most frequent ones were failure to achieve the procedure (1.16%), and nerve lesions (1.17%). Cartilage lesions and complex regional pain syndrome each occurred in 0.50% cases. Other complications (wrist stiffness, loose bodies, hematomas, tendon lacerations) were less frequent. Breaking down of the data according to each surgeon's experience of the technique showed a significant relationship with the rate of complications, the threshold for a lower complication rate being approximately 25 arthroscopies a year and/or greater than 5 years of experience. Conclusion Although the global incidence of complications was in keeping with the literature, the incidence of serious complications was much higher than previously reported. There is a significant learning curve with the technique of wrist arthroscopy, both in terms of volume and experience.