The complication rate in arthroscopic surgery is presumed to be very low. However, because of the frequency at which arthroscopic procedures are performed, these complications are not rare. It is estimated that over 1 million arthroscopic procedures are performed each year in the United States. Even with a complication rate of 1%, this would amount to over 10,000 complications occurring yearly. Further, although arthroscopy was previously assumed to be a “simple” surgery, advances in instrumentation, indications, and knowledge have led to an increasing complexity of surgeries being performed and, along with it, to increasing opportunities for complications.
Every surgeon has complications – often it is just a matter of recognizing them and admitting that they do occur. Complications can range from a mere nuisance, such as a superficial stitch reaction, to a tragedy, such as a fatal pulmonary embolus. Complications not only affect the patient, but also often affect the surgeon, with emergent surgeries, admissions and patient care, altering professional and personal schedules.
A complication is defined as a “difficult factor or issue often appearing unexpectedly and changing existing plans, methods or attitudes.” This issue of Sports Medicine and Arthroscopy Review is dedicated to helping the reader become aware of potential complications in arthroscopic surgery and also to assist him or her in understanding the proper treatment of complications when they do occur. Complications associated with hip, knee, ankle, shoulder, elbow, and wrist arthroscopy have been discussed by surgeons with vast experience in these specific anatomic areas. Experts in osteotomies, cartilage restoration, patellofemoral surgery, and anterior cruciate ligament reconstruction and revision describe their experience and review the literature on complications unique to these types of surgeries. Complications common to all types of arthroscopic surgery, such as thromboembolic disease and infection, are also discussed in detail.
It has been an honor to serve as guest editor for this issue of Sports Medicine and Arthroscopy Review, and I would like to sincerely thank the authors for their contributions of knowledge, expertise, and time to make this issue a comprehensive review of recognition, avoidance, and treatment of complications in arthroscopic surgery.