Complications of Knee Arthroscopy

POTENTIAL COMPLICATIONS OF KNEE ARTHROSCOPY

Rhidian Morgan-Jones

INFECTION

Despite surgery under sterile conditions, infection is still a potential complication of all operations. Post-operative infection maybe:

a)SuperficialWounds only and usually settles with antibiotics.

b)DeepInvolving the joint. Requires further surgery to washout the joint and intravenous antibiotics. May lead to joint stiffness and early degeneration.

DEEP VENOUS THROMBOSIS & PULMONARY EMBOLUS

A blood clot in the deep veins of the calf or thigh is a complication of any lower limb surgery. The treatment is anti-coagulation for 3-6 months.

A blood clot that breaks-off and travels to the lungs is called a Pulmonary Embolus. This is a rare but life threatening complication. The treatment is anti-coagulation for 3-6 months.

HAEMARTHROSIS

Bleeding within the knee joint can complicate any surgical procedure. A haemarthrosis will usually respond to ice, rest and physiotherapy but can lead to delayed recovery and joint stiffness.

WOUND HEALING

Although arthroscopy is performed through 'Key Hole" incisions there is still a possibility of delayed wound healing. This may results in a serous discharge from the wounds for a short period after surgery and usually settles spontaneously. Occasionally the arthroscopy portals can produce a small local hernia of fatty tissue from within the knee. This rarely causes any clinical problems.

NERVE INJURY

Small areas of numbness may be associated with the operative incisions. The numbness is usually temporary. Occasionally wounds can become painfully sensitive, although this normally settles with time.

REFLEX SYMPATHETIC DYSTROHY

Reflex Sympathetic dystrophy is a little understood condition, which can complicate any operation. It consists of regional pain, swelling, sweating and stiffness due to local overactivity of the sympathetic nerves triggered by surgery, however minor.

COMPARTMENT SYNDROME

A rare complication where fluid used to dilate and irrigate the knee joint tracks into the muscle compartments of the calf. Increased pressure within the calf can compromise the nerve and blood supply of the lower leg and requires emergency surgery to decompress the leg.