Complications in meniscal surgery

Abstract

Arthroscopic meniscal surgeries are among the most common procedures performed by the orthopedist today. As such, it is in the best interest of all orthopedists to be able to recognize potential complications common with these surgeries so that they can potentially be avoided. This paper first addresses potential complications seen in arthoscopic knee surgeries in general including infection, arthrofibrosis, reflex sympathetic dystrophy, and deep venous thrombosis, among others. Other complications are more specific for certain types of meniscal surgery. In meniscal repair, iatrogenic damage to the neurovasculature including the peroneal nerve, the saphenous nerve, and the popliteal artery are a significant concern to both the orthopedist and the patient. Newer all-inside repair techniques promise to minimize these neurovascular risks but have a new set of potential pitfalls. To make an educated decision on which type of repair to perform, the orthopedist must be familiar with the complications associated with each technique. Meniscectomy has a different set of complications, notably late osteoarthritic degenerative changes seen in postmeniscectomy knees. Meniscal transplantation has its own unique pitfalls including allograft extrusion and graft shrinkage. It is our hope that by relaying the potential risks associated with these procedures, the surgeon will be more cognizant of and take steps to minimize the occurrence of these pitfalls.