Werner Brian C, Cancienne Jourdan M, Miller Mark D, Gwathmey F Winston
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
Am J Sports Med. 2015 Jul;43(7):1656-61. doi: 10.1177/0363546515578660. Epub 2015 Apr 16.
Arthrofibrosis after knee arthroscopy is a challenging complication. Previous studies reporting incidences of manipulation under anesthesia (MUA) or lysis of adhesions (LOA) after knee arthroscopy are limited by confounders such as small sample size and regional sampling bias.
To investigate the incidence of MUA or LOA after common arthroscopic knee procedures.
Descriptive epidemiology study.
A national insurance database was retrospectively queried for arthroscopic knee procedures from 2007 to 2011. The incidence of postoperative MUA and LOA within 3 and 6 months postoperatively was determined for each of 13 common arthroscopic knee surgeries, including ligamentous reconstructive procedures, cartilage restoration procedures, and meniscal procedures.
A total of 330,714 unique patients who underwent knee arthroscopy were included in the study. The overall incidence of MUA was 0.06% to 6.00% by 3 months and 0.11% to 8.00% by 6 months postoperatively. The incidence of LOA was somewhat less, ranging from 0.04% to 4.00% by 3 months and 0.06% to 6.00% by 6 months postoperatively. Isolated arthroscopic partial meniscectomy had the lowest incidence of postoperative MUA and LOA, while multiligament reconstructions and meniscal transplants had the highest incidences.
The overall incidence of MUA and LOA after arthroscopic knee procedures is low but rises significantly as the number of concomitant procedures or complexity of the procedures increases. This information may be useful in counseling patients on the likelihood of MUA or LOA based on the type of arthroscopic knee procedure that is planned.
膝关节镜检查术后关节纤维化是一种具有挑战性的并发症。以往关于膝关节镜检查后麻醉下手法操作(MUA)或粘连松解术(LOA)发生率的研究受到样本量小和区域抽样偏差等混杂因素的限制。
调查常见膝关节镜手术术后MUA或LOA的发生率。
描述性流行病学研究。
对国家保险数据库进行回顾性查询,以获取2007年至2011年期间的膝关节镜手术信息。确定了13种常见膝关节镜手术术后3个月和6个月内MUA和LOA的发生率,包括韧带重建手术、软骨修复手术和半月板手术。
共有330714例接受膝关节镜检查的患者纳入本研究。术后3个月时MUA的总体发生率为0.06%至6.00%,术后6个月时为0.11%至8.00%。LOA的发生率略低,术后3个月时为0.04%至4.00%,术后6个月时为0.06%至6.00%。单纯关节镜下部分半月板切除术术后MUA和LOA的发生率最低,而多韧带重建术和半月板移植术的发生率最高。
膝关节镜手术后MUA和LOA的总体发生率较低,但随着同期手术数量或手术复杂性的增加而显著上升。这些信息可能有助于根据计划进行的膝关节镜手术类型,向患者提供关于MUA或LOA可能性的咨询。