The burden of arthroscopy of the knee

Abstract

Arthroscopy of the knee is one of the most commonly performed orthopaedic procedures worldwide. Large-volume outcome data have not previously been available for English NHS patients. Prospectively collected admissions data, routinely collected on every English NHS patient, were analysed to determine the rates of complications within 30 days (including re-operation and re-admission), 90-day symptomatic venous thromboembolism and all-cause mortality. There were 301,701 operations performed between 2005 and 2010--an annual incidence of 9.9 per 10,000 English population. Of these, 16,552 (6%) underwent ligament reconstruction and 106,793 (35%) underwent meniscal surgery. The 30-day re-admission rate was 0.64% (1662) and 30-day wound complication rate was 0.26% (677). The overall 30-day re-operation rate was 0.40% (1033) and the 90-day pulmonary embolism rate was 0.08% (230), of which six patients died. 90-day mortality was 0.02% (47). Age < 40 years, male gender and ligament reconstruction were significantly associated with an increased rate of 30-day re-admission and unplanned re-operation. In addition, a significant increase in 30-day admission rates were seen with Charlson comorbidity scores of 1 (p = 0.037) and ≥ 2 (p < 0.001) compared with scores of 0, and medium volume units compared with high volume units (p < 0.001). Complications following arthroscopy of the knee are rare. It is a safe procedure, which in the majority of cases is performed as day case surgery. These data can be used for quality benchmarking, in terms of consent, consultant re-validation and individual unit performance.

Transfer of arthroscopic skills from computer simulation training to the operating theatre: a review of evidence from two randomised controlled studies

“…With an estimated incidence of 10 knee arthroscopic procedures per 10,000 population performed in the National Health Service (NHS) in England annually, there is clearly a need to consider the evidence for improved teaching modality for this specific skill set [ 17 ]. Two recent systematic reviews demonstrated a high level of internal consistency and validity using simulators for arthroscopy skills training.…”

Transient Common Peroneal and Tibial Nerve Palsy Following Knee Arthroscopy for the Treatment of Discoid Lateral Meniscus

“…Most of the information regarding complications after knee arthroscopy dates back to the 1980s, with rates ranging between 0.6 and 8.2%. 2 3 4 A review of the literature found few recent reports 5 6 showing a decrease in overall complications rates that may be due to advances in equipment, the evolution of techniques, and increased familiarity of the surgeons with arthroscopic procedures.…”

In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

“…The complications evaluated were those seen with standard arthroscopy. The complication rates used for knee arthroscopy were derived from a recent article (2011) appearing in the Journal of Bone and Joint Surgery [34] (Table 2). The complication rates applied to the costs of shoulder arthroscopy were also derived from the literature [35,36] (Table 3).…”