Sports Surgery: Treatment Complications of Pediatric Knee Arthroscopic Surgery

Ozan RAZIa , Ozan Ali ERDALb

aLefkoşa Dr. Burhan Nalbantoğlu State Hospital, Clinic of Orthopedics and Traumatology, Nicosia, TRNC
bPrivate Physician, İstanbul, Türkiye

ABSTRACT
Sports injuries of the knee joint has been more commonly encountered in children. Arthroscopic treatment has been the preferred choice. Although the procedure is considered safe, possible complications related to it have been reported. Overall complication rates were 0,56-16%. Complications were divided into major and minor according to the severity. The most common complications are local deep or superficial wound complications and return to the operating room. Pulmonary embolism has been studied many times due to its devastating results. Although some controversy is still present for routine prophylaxis, most of the studies agree for risk factor analysis before the procedure and application of prophylaxis accordingly. Procedure specific complications were studied especially for anterior cruciate ligament reconstructions and listed as re-rupture and growth disorders. The surgeon must take precautions against the increasing number of complications with increased knee injuries in pediatric athletes, although the rates have been low.
Keywords: Knee injuries; arthroscopy; complications

Referanslar

  1. Purvis JM, Burke RG. Recreational injuries in children: incidence and prevention. J Am Acad Orthop Surg. 2001;9(6):365-74. [Crossref]  [PubMed]
  2. Ergen E. Sports injuries in children and adolescents: etiology, epidemiology, and risk factors. Acta Orthop Traumatol Turc. 2004;38 Suppl 1:27-31.
  3. Sørensen L, Larsen SE, Röck ND. The epidemiology of sports injuries in school-aged children. Scand J Med Sci Sports. 1996;6(5):281-6. [Crossref]  [PubMed]
  4. Maffulli N, Longo UG, Gougoulias N, Caine D, Denaro V. Sport injuries: a review of outcomes. Br Med Bull. 2011;97:47-80. [Crossref]  [PubMed]
  5. Wong SE, Feeley BT, Pandya NK. Complications After Pediatric ACL Reconstruction: A Meta-analysis. J Pediatr Orthop. 2019;39(8):e566-e71. [Crossref]  [PubMed]
  6. Ashraf A, Luo TD, Christophersen C, Hunter LR, Dahm DL, McIntosh AL. Acute and subacute complications of pediatric and adolescent knee arthroscopy. Arthroscopy. 2014;30(6):710-4. [Crossref]  [PubMed]
  7. Ellis HB Jr, Sabatino MJ, Clarke Z, Dennis G, Fletcher AL, Wyatt CW, et al. The Importance of a Standardized Screening Tool to Identify Thromboembolic Risk Factors in Pediatric Lower Extremity Arthroscopy Patients. J Am Acad Orthop Surg. 2019;27(9):335-43. [Crossref]  [PubMed]
  8. Murphy RF, Heyworth B, Kramer D, Naqvi M, Miller PE, Yen YM, et al. Symptomatic Venous Thromboembolism After Adolescent Knee Arthroscopy. J Pediatr Orthop. 2019;39(3):125-9. [Crossref]  [PubMed]
  9. Accadbled F. Arthroscopic surgery in children. Orthop Traumatol Surg Res. 2010;96(4):447-55. [Crossref]  [PubMed]
  10. Martin CT, Pugely AJ, Gao Y, Wolf BR. Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database. J Bone Joint Surg Am. 2013;95(14):e98 1-10. [Crossref]  [PubMed]
  11. Hartwell MJ, Morgan AM, Johnson DJ, Nicolay RW, Christian RA, Selley RS, et al. Risk Factors for 30-Day Readmission following Knee Arthroscopy. J Knee Surg. 2020;33(11):1109-15. [Crossref]  [PubMed]
  12. Sherman WF, Verzeaux NP, Freiberger C, Lee OC, Wilder JH, Flick TR, et al. Local and Systemic Complications of Knee and Hip Arthroscopy: A Matched-Cohort Study. Orthop J Sports Med. 2022;10(11):23259671221131059. [Crossref]  [PubMed]  [PMC]
  13. Gunnlaugsdóttir SL, Erlendsdóttir H, Helgason KO, Geirsson ÁJ, Thors V, Guðmundsson S, et al. Native joint infections in Iceland 2003-2017: an increase in postarthroscopic infections. Ann Rheum Dis. 2022;81(1):132-9. [Crossref]  [PubMed]  [PMC]
  14. Balato G, Di Donato SL, Ascione T, D'Addona A, Smeraglia F, Di Vico G, et al. Knee Septic Arthritis after Arthroscopy: Incidence, Risk Factors, Functional Outcome, and Infection Eradication Rate. Joints. 2017;5(2):107-13. [Crossref]  [PubMed]  [PMC]
  15. Rocco P, Lorenzo DB, Guglielmo T, Michele P, Nicola M, Vincenzo D. Radiofrequency energy in the arthroscopic treatment of knee chondral lesions: a systematic review. Br Med Bull. 2016;117(1):149-56. [Crossref]  [PubMed]
  16. Carr JB 2nd, Cancienne JM, Werner BC. Obstructive sleep apnea affects complication rates following knee arthroscopy but use of continuous positive airway pressure is not protective against complications. Knee Surg Sports Traumatol Arthrosc. 2019;27(2):534-40. [Crossref]  [PubMed]
  17. Nicolay RW, Selley RS, Terry MA, Tjong VK. Body Mass Index as a Risk Factor for 30-Day Postoperative Complications in Knee, Hip, and Shoulder Arthroscopy. Arthroscopy. 2019;35(3):874-82.e3. [Crossref]  [PubMed]
  18. Berlinberg EJ, Patel HH, Ogedegbe B, Forlenza EM, Chahla J, Mascarenhas R, et al. Postoperative, But Not Preoperative Coronavirus Disease 2019 (COVID-19), Is Associated With an Increased Rate of Medical Adverse Events Following Arthroscopic Procedures. Arthrosc Sports Med Rehabil. 2022;4(4):e1269-e76. [Crossref]  [PubMed]  [PMC]
  19. Bauer T, Boisrenoult P, Jenny JY. Post-arthroscopy septic arthritis: Current data and practical recommendations. Orthop Traumatol Surg Res. 2015;101(8 Suppl):S347-50. [Crossref]  [PubMed]
  20. Wendt MC, Spinner RJ, Shin AY. Iatrogenic transection of the peroneal and partial transection of the tibial nerve during arthroscopic lateral meniscal debridement and removal of osteochondral fragment. Am J Orthop (Belle Mead NJ). 2014;43(4):182-5.
  21. Huang HF, Tian JL, Sun L, Yang XT, Shen YK, Li SS, et al. The effect of anticoagulants on venous thrombosis prevention after knee arthroscopy: a systematic review. Int Orthop. 2019;43(10):2303-8. [Crossref]  [PubMed]
  22. Nemeth B, Cannegieter SC. Venous thrombosis following lower-leg cast immobilization and knee arthroscopy: From a population-based approach to individualized therapy. Thromb Res. 2019;174:62-75. [Crossref]  [PubMed]
  23. Jeon SH, Kwon GH, Kim MS. Symptomatic bilateral massive pulmonary embolism and proximal and distal deep vein thrombosis following arthroscopic meniscus surgery: A case report. Medicine (Baltimore). 2021;100(13):e25372. [Crossref]  [PubMed]  [PMC]
  24. Engler ID. Editorial Commentary: Prophylaxis Against Deep Venous Thrombosis Should Be the Norm After Knee Arthroscopy. Arthroscopy. 2022;38(12):3192-3. [Crossref]  [PubMed]
  25. Martinazzi BJ, Kirchner GJ, Lorenz FJ, Bonaddio V, Hines S, Kim RY, et al. Venous Thromboembolism Chemoprophylaxis in Knee Arthroscopy: A Break-Even Analysis of Cost. Am J Sports Med. 2022;50(14):3832-7. [Crossref]  [PubMed]  [PMC]
  26. Holler JT, Salesky M, Halvorson RT, Zhang AL, Ma CB, Feeley BT, et al. Perioperative Thromboprophylaxis Is Associated With Lower Risk of Venous Thromboembolism After Knee Arthroscopy. Arthroscopy. 2022;38(12):3184-91. [Crossref]  [PubMed]
  27. Georgopoulos G, Hotchkiss MS, McNair B, Siparsky G, Carry PM, Miller NH. Incidence of Deep Vein Thrombosis and Pulmonary Embolism in the Elective Pediatric Orthopaedic Patient. J Pediatr Orthop. 2016;36(1):101-9. [Crossref]  [PubMed]  [PMC]
  28. Lau BC, Jagodzinski J, Pandya NK. Incidence of Symptomatic Pulmonary Embolus and Deep Vein Thrombosis After Knee Arthroscopy in the Pediatric and Adolescent Population. Clin J Sport Med. 2019;29(4):276-80. [Crossref]  [PubMed]
  29. Reid D, Leigh W, Wilkins S, Willis R, Twaddle B, Walsh S. A 10-year Retrospective Review of Functional Outcomes of Adolescent Anterior Cruciate Ligament Reconstruction. J Pediatr Orthop. 2017;37(2):133-7. [Crossref]  [PubMed]
  30. Lins LAB, Feroe AG, Yang B, Williams KA, Kocher SD, Sankarankutty S, et al. Long-term Minimum 15-Year Follow-up After Lateral Discoid Meniscus Rim Preservation Surgery in Children and Adolescents. J Pediatr Orthop. 2021;41(9):e810-e5. [Crossref]  [PubMed]