English

Abstract

Introduction The purpose of this study was to evaluate the complications of arthroscopic partial meniscectomy, especially in the early stages of experience with a review of literature. Materials and methods About 170 patients in the age group of 18–50 years, who underwent arthroscopic partial meniscectomy for isolated meniscal tears volunteered for the study. Results The intraoperative complications were malpositioning of portals (n = 7), difficulty in identifying the components of the tear (n = 11), damage to the articular cartilage (n = 12), excessive resection of the meniscus (n = 8), breakage of blade during portal making (n = 2), breakage of the punch forceps (n = 1), and prolonged surgical time (n = 30). The postoperative complications were haemarthrosis (n = 1), persistent swelling (n = 22), portal site tenderness (n = 12), deep venous thrombosis (n = 2), saphenous nerve injury (n = 1). However, we did not observe any infections (superficial or deep). Most of the intraoperative complications were observed during the initial surgeries. Conclusion Arthroscopic partial meniscectomy is a minimally invasive procedure which, in well-selected patients, is a method of choice for treatment of meniscal injuries when repair techniques are not a viable option. It has low morbidity, fast rehabilitation, and low cost of care. However, even this procedure is not without complications, especially for surgeons who have just started doing the procedure. Since arthroscopy has a steep learning curve, the incidence of complications decreases with the experience of the surgeon. Introduction The wheel has turned full cycle for the menisci, contrary to the previously described ‘functionless’ structure within the knee to the view that they are, indeed, crucial components of the normal biomechanics and functioning of the knee.1 The menisci participate in many important functions, including tibio– femoral load transmission, shock absorption, lubrication, and passive stabilization of the knee joint.2–8 The advent of arthroscopy in the 1970s and a greater understanding of the natural history and long term sequelae of open meniscectomy resulted in a greater emphasis on meniscal preservation by partial meniscectomy/ repair.9 The surgical indications for arthroscopic treatment of meniscal pathology include symptoms of meniscal injury that affect activities of daily living, work, and/or sports; positive physical findings of joint line tenderness, joint effusion, limitation of motion, and provocative signs, such as pain with squatting or a positive McMurray or Apley grind test; failure to respond to non-surgical treatment, including activity modification, medication, a rehabilitation programme; and absence of other causes of knee pain identified on plain radiographs or other imaging studies. Arthroscopic partial meniscectomy, where only damaged or unstable parts of the meniscus are removed leaving the remainder of the meniscus intact, has become an almost routine treatment of the menisci, thus providing early relief from pain, eliminating mechanical symptoms caused by unstable meniscal fragments and allowing early weight bearing, return of the function, significantly reduced morbidity, and reduction of the cost of care.9 Arthroscopy is not an entirely safe procedure. Arthroscopic surgery can be, in some cases, life-threatening and may cause unusual complications. A good preoperative and intraoperative planning and attention to the details of the basic techniques can prevent most of the complications. Familiarity with new techniques through learning centres, operating with colleagues, videos, and staying current with speciality journals allows the surgeon to gain valuable information from the experiences of other colleagues. The present study was carried out to document the complications during arthroscopic partial meniscectomies surgeries and review the literature regarding these complications. Materials and methods This work conforms to the values laid down in the Declaration of Helsinki (1964). The protocol of this study has been approved by the relevant ethical committee related to our institution in which it was performed. All subjects gave full informed consent to participate in this study. * Corresponding author Email: drnasir@in.com Department of Orthopaedics, Hospital for Bone and Joint Surgery, Barzalla, Srinagar, Kashmir, India. A rt hr os co py