Teissier Victoria, Pujol Nicolas
Department of Orthopedic Surgery, Centre Hospitalier de Versailles, Le Chesnay, France.
Arch Orthop Trauma Surg. 2023 Apr;143(4):2055-2062. doi: 10.1007/s00402-022-04522-1. Epub 2022 Jul 1.
The purpose of this study was to report the proportion and cause of unplanned revision surgery rates within 1 year following arthroscopic procedures. Our hypothesis was that there is a significant rate of unplanned returns (URs) occurring between 3 and 12 months after the initial procedure and that causes of revision are different when considering the delay after the index surgery.
Among 4142 consecutive patients who underwent an arthroscopic procedure in a single department of orthopedics and traumatology, patients undergoing revision surgery for any reasons directly related to the primary procedure were included. Cause for revision, surgical site, delay from index procedure, and number of revisions were screened.
Seventy-eight patients underwent 97 revision surgeries (2.3%) for reasons directly related to the primary procedure. Most revision surgeries were performed after month 3 following index surgery (59 patients, 60.8%). Mean time to revision surgery was 5.3 ± 4.3 months (range 0-365 days). Usual early-onset (< 3 months) reasons for unplanned revision were surgical site infection (17 patients, 0.41%), wound-healing defect (12 patients, 0.29%), and hemorrhagic complication (7 patients, 0.17%). Reasons for delayed unplanned revision (> 3 months) were index procedure failure (21 patients, 0.51%), stiffness (18 patients, 0.43%), and removal of hardware (16 patients, 0.41%).
Reasons for return to the operating room (OR) are different depending on the timepoint from index procedure. Patients should receive relevant information accordingly when scheduling any arthroscopic procedure, including up to 1-year potential complications.
Prognostic study, Case series, Level IV.
本研究的目的是报告关节镜手术后1年内计划外翻修手术率的比例及原因。我们的假设是，在初次手术后3至12个月之间存在显著的计划外返回率（URs），并且在考虑初次手术后的延迟时间时，翻修原因有所不同。
在某单一骨科创伤科连续接受关节镜手术的4142例患者中，纳入因与初次手术直接相关的任何原因而接受翻修手术的患者。筛选翻修原因、手术部位、初次手术后的延迟时间以及翻修次数。
78例患者因与初次手术直接相关的原因接受了97次翻修手术（2.3%）。大多数翻修手术在初次手术后第3个月之后进行（59例患者，60.8%）。翻修手术的平均时间为5.3±4.3个月（范围0 - 365天）。计划外早期翻修（<3个月）的常见原因是手术部位感染（17例患者，0.41%）、伤口愈合缺陷（12例患者，0.29%）和出血并发症（7例患者，0.17%）。延迟计划外翻修（>3个月）的原因是初次手术失败（21例患者，0.51%）、僵硬（18例患者，0.43%）和取出内固定物（16例患者，0.41%）。
返回手术室的原因因距初次手术的时间点而异。在安排任何关节镜手术时，患者应相应地获得相关信息，包括长达1年的潜在并发症。
预后研究，病例系列，IV级。
