Increased Age, Operative Time, American Society of Anesthesiologists Classification, Functional Dependency, and Comorbidity Burden Are Risk Factors for Adverse Events After Meniscectomy and Meniscus Repair: 10-Year Analysis of 64,223 Patients

Abstract

To use the National Surgical Quality Improvement Program (NSQIP) database to identify risk factors for 30-day adverse events and hospital readmission following isolated and unilateral meniscectomy or meniscus repair. A retrospective review of the NSQIP database from the years 2012 to 2021 identified all patients undergoing isolated, unilateral meniscectomy or meniscus repair. Multivariable analyses were performed for each procedure to identify patient characteristics associated with any adverse event (AAE) or unplanned hospital readmission within 30 days of surgery. From 2012 to 2021, 59,450 (93%) patients underwent meniscectomy, and 4,773 (7%) patients underwent meniscus repair. Overall adverse event rate was 0.95% after meniscectomy and 1.40% after repair. Risk factors for AAE after meniscectomy included increased age (odds ratio [OR]= 1.010; P= .009), increased operative time (OR= 1.003; P= 0.011), American Society of Anesthesiologists (ASA) class IV (OR= 2.048; P= .045), functional dependency (OR= 3.527; P= .001), and current smoking (OR= 1.308; P= .018). Risk factors for AAE after meniscus repair included age (OR= 1.024; P= .016), operative time (OR= 1.004; P= .038), and bleeding disorders (OR= 7.000; P= .014). ASA class III increased risk of hospital readmission after both procedures (OR=1.906; P= .008; OR= 4.101; P= .038), and medical comorbidities of heart failure (OR= 3.924; P=.016), hypertension (OR= 1.412; P= .011), and chronic obstructive pulmonary disease (OR = 2.350; P < .001) increased readmission risk after meniscectomy only. Per analysis of the American College of Surgeons (ACS)-NSQIP database, surgical treatment of meniscal tears in the knee has been performed frequently over the past 10 years, with meniscectomies comprising over 90% of cases. Increased age and operative time were associated with a modest risk of adverse events after both meniscectomy and meniscus repair. Increased comorbidity burden, evidenced by ASA class, dependent functional status, current smoking, and systemic medical conditions, such as heart failure, hypertension, chronic obstructive pulmonary disease, and bleeding disorders, greatly increased rates of unfavorable outcomes within 30 days of meniscus surgery. Level III, retrospective prognostic comparative investigation.