Risk Factors for Complication after Knee and Shoulder Arthroscopy

The risk of complication after a knee or shoulder arthroscopy is extremely low. Studies have found the rate of complication after shoulder arthroscopy to be 0.86% and complication after knee arthroscopy to be 0.92%. These rates are so low due to the fact that arthroscopic procedures utilize small incisions that heal faster, create less trauma, and help to minimize infection.

However, even with these low rates of complications, how can complications be further prevented? Understanding the risk factors for complications is the first step. Studies have found that the biggest risk factors are: older than 80 years of age, chronic steroid use, and comorbid conditions. Examples of comorbid conditions include: diabetes, high blood pressure, COPD, and obesity. The most common complications after arthroscopy include surgical-site infection, blood clot, and post-operative pain.

What can we do with this information? Patient’s with comorbid conditions should make sure their condition is well controlled before undergoing a surgical procedure. Patients who have been taking chronic steroids should check with their primary care physician to see if the steroids can be discontinued. If not and a surgical procedure is required, they will have to followed closely to watch for signs of infection.

Patients who are immunocompromised (have a weak immune system due to a chronic condition or chronic steroid use), have diabetes, or smoke are at increased risk for infection. Therefore, it is very important to have diabetes well controlled and to stop smoking prior to surgical procedures.

After arthroscopy, we recommend that patients pump/move their ankle (if it was knee surgery) and make fists (if it was shoulder surgery) to keep blood flowing and prevent a blood clot.

Overall, the risk of complication after an arthroscopic procedure is extremely low (less than 1%). But to further decreased the risk of complications, patients should make sure their comorbid conditions are well controlled, they have ceased smoking, and they start moving the extremity early after surgery.

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