Adverse outcomes associated with elective knee arthroscopy: a population-based cohort study

Area of Science:

• Orthopaedic Surgery
• Public Health
• Epidemiology

Background:

• Elective knee arthroscopies are common procedures.
• Understanding adverse outcomes is crucial for patient safety.
• Identifying risk factors can guide preventative strategies.

Purpose of the Study:

• To quantify adverse outcomes following elective knee arthroscopies in Victoria, Australia.
• To identify patient and procedural risk factors associated with these adverse outcomes.

Main Methods:

• Retrospective, longitudinal cohort study using the Victorian Admitted Episodes database (2000-2009).
• Included elective orthopaedic admissions for knee arthroscopy.
• Adverse outcomes included DVT, PE, hemarthrosis, effusion, synovitis, infections, and death within 30 and 90 days.

Main Results:

• Over 180,000 procedures were analyzed, with 0.64% experiencing adverse outcomes.
• Most common complications were DVT (0.36% within 90 days), PE (0.10% within 90 days), effusion/synovitis (0.09%), and hemarthrosis (0.07%).
• Risk factors included older age, comorbidities, being married, major mechanical issues, and public hospital procedures.

Conclusions:

• Elective knee arthroscopy has a low rate of adverse events, but significant complications like DVT and PE occur.
• Risk factors such as chronic kidney disease, myocardial infarction, cerebrovascular accident, and cancer are associated with adverse outcomes.
• These findings can inform patient selection and perioperative management to improve safety.