Acute and subacute complications of pediatric and adolescent knee arthroscopy.
OBJECTIVE
The purposes of this study were to determine the frequency of acute and subacute complications (within 6 months) of arthroscopic knee procedures in patients aged 17 years or younger and to determine associated risk factors.


METHODS
We identified all patients aged 17 years or younger who underwent arthroscopic knee procedures at our institution from 1997 to 2009. Patient demographic and surgical data were collected from the medical and surgical records, with specific focus on intraoperative and postoperative complications.


RESULTS
During the study period, 1,002 knee arthroscopies were reviewed. The overall complication rate was 14.7%. Major complications occurred in 21 surgeries (2.1%) and included the following: septic arthritis (n = 3, 0.3%), wound complication requiring operative revision (n = 9, 0.9%), arthrofibrosis requiring manipulation (n = 4, 0.4%), other unplanned subsequent surgery (n = 4, 0.4%), and death (n = 1, 0.1%). Surgeries with an anesthesia time of 265 minutes or greater (P = .026), operative time of 220 minutes or greater (P = .013), or tourniquet time of 114 minutes or greater (P < .001) and surgeries with 3 or more Current Procedural Terminology codes (P = .003) had a statistically significant increase in risk of major complications. The incidence of minor complications was 12.6%, which included persistent effusion/hemarthrosis requiring arthrocentesis (n = 59, 5.9%) and superficial wound infection (n = 18, 1.8%).


CONCLUSIONS
Major complications after knee arthroscopy in children and adolescents are rare, but minor complications are more common. If possible, surgeons should avoid prolonged anesthesia, surgery, and tourniquet times. The pediatric patient's medical and family history should be reviewed to identify important risk factors.


METHODS
Level IV, therapeutic case series.
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Ali
A
Ashraf
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
T David
TD
Luo
University of Minnesota Medical School, Duluth, Minnesota, U.S.A.
Christy
C
Christophersen
College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
Lindsay R
LR
Hunter
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Diane L
DL
Dahm
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.. Electronic address: McIntosh.Amy@mayo.edu.
Amy L
AL
McIntosh
D000208:Acute Disease; D000293:Adolescent; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000209:etiology; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors