[Arthroscopy of the knee--"surgery without complications"].

INTRODUCTION

Beside other advantages that arthroscopic surgery has, comparing to the open surgery, there is one more--the risk of complications is present but a very little. The aim of this work is to present complications that we have had and to point at possibilities how to prevent and treat them.

MATERIAL, METHODS AND RESULTS: In the period from September 1990 to December 1998, 1071 arthroscopic surgeries were performed in our hospital. 817 patients (76%) were male and 254 (24%) female, average age 30.63 (12-69). Left knee was involved in 560, while the right in 511 cases. Among all arthroscopic interventions 463 (43.23%) were diagnosed when damages of LCA or cartilage were seen, and 608 (56.76%) were patients with therapeutic arthroscopic interventions. Among different arthroscopic interventions medial meniscectomy was performed in 417 (38.93%) patients, lateral in 124 (11.57%), removal of joint loose bodies in 39 (3.64%), reconstruction of LCA in 29 (2.70%), operation on patellar and condylar cartilage in 26 (2.42%) etc. There were 39 (3.64%) complications. 10 (25.64%) of them were intraoperative (breakage of arthroscopic instruments, loss of meniscal parts, extravasation of the fluid in extremity and 29 (74.35%) of them were postoperative (infection, synovial sinus, thrombophlebitis, haemarthrosis, synovial effusion, painful scar). 8 (1.72%) of those complications appeared after diagnostic arthroscopy and 31 (5.09%) after different therapeutic arthroscopic procedures.

DISCUSSION

Advantages of arthroscopic surgery are exhibited in different ways (shortening hospital stay, lower cost of treatment, shortening the time necessary for complete recovery and return to everyday life and sport activities), while the risk of complications, although possible, is significantly diminished. Insufficient education, improvisation, rude manipulation, unprecise++ surgical approaches to the knee joint lead to aforementioned complications. Our results are discussed and compared to those found in the literature giving suggestions in the same time how to avoid and prevent them.

CONCLUSION

Orthopedic surgeons who perform arthroscopic surgery must be well trained and familiar with the arthroscopic procedures and able to prevent and overcome possible complications. Continual education and training is necessary for arthroscopic surgeons in order to be able to follow innovations in surgical techniques and instrumentation.