Complications of knee arthroscopic surgeries in China: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Kaibo , MAO Beini , ZHANG Zhong , LAI Sike , LI Jian ,  FU Weili

Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

FU Weili, Email: foxwin2008@163.com

Keywords：

Knee arthroscopy; Complication; Incidence; Rate; Systematic review; Meta-analysis; Cross-sectional study

DOI：

10.7507/1672-2531.201907138

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the complications of knee arthroscopic surgeries in China.Methods We searched PubMed, EMbase, CNKI, WanFang Data and VIP databases to collect cross-sectional studies on the complications of knee arthroscopic surgeries in China from inception to March 1^st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.Results A total of 36 studies involving 20 740 cases were included. The results of meta-analysis showed the incidence rate of complication in knee arthroscopic surgeries in China was 9.71% (95%CI 8.20% to 11.23%). Subgroup analysis showed that the complication incidence rates in the eastern, central and western regions were 10.04% (95%CI 8.00% to 12.14%), 9.67% (95%CI 6.57% to 12.76%) and 7.47% (95%CI 6.20% to 8.73%). The complication incidence rates in the upper first-class and non-upper first-class hospitals were 9.50% (95%CI 7.83% to 11.17%) and 10.95% (95%CI 6.75% to 15.14%). The top 3 complication types with highest incidence rate included joint effusion［2.16% (95%CI 1.44% to 2.87%)］, accidental injury of native structures［1.49% (95%CI 0.96% to 2.03%)］ and hemorrhage［1.43% (95%CI 1.01% to 1.84%)］. Other severe complications including neurovascular injury, thrombosis diseases and infection were 0.06% (95%CI 0.02% to 0.11%), 0.33% (95%CI 0.19% to 0.48%) and 0.08% (95%CI 0.03% to 0.13%).Conclusions Current evidence shows that the complication incidence rate of arthroscopic surgeries in China is relatively high and the complication type is complex and varied. Due to the quantity and quality of the included studies, more high-quality studies are required to verify the above conclusions in future.

Citation： ZHANG Kaibo, MAO Beini, ZHANG Zhong, LAI Sike, LI Jian, FU Weili. Complications of knee arthroscopic surgeries in China: a systematic review. Chinese Journal of Evidence-Based Medicine, 2019, 19(12): 1400-1408. doi: 10.7507/1672-2531.201907138 Copy

1.	Small, NC. Complications in arthroscopy: the knee and other joints: committee on complications of the Arthroscopy Association of North America. Arthroscopy, 1986, 2(4): 253-258.
2.	Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy, 1988, 4(3): 215-221.
3.	Hagino T, Ochiai S, Watanabe Y, et al. Complications after arthroscopic knee surgery. Arch Orthop Trauma Surg, 2014, 134(11): 1561-1564.
4.	Owens DK, Lohr KN, Atkins D, et al. AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions--agency for healthcare research and quality and the effective health-care program. J Clin Epidemiol, 2010, 63(5): 513-523.
5.	张春礼, 李明全, 范宏斌, 等. 膝关节镜手术并发症及其防治. 中国微创外科杂志, 2003, 3(4): 303-305.
6.	闫长明, 王斌. 630 例膝关节镜手术并发症分析及防治对策. 中国内镜杂志, 2014, 20(3): 294-297.
7.	李晓东, 王远菊, 张之智, 等. 3 760 例膝关节镜手术并发症临床分析及处理. 中国伤残医学, 2013, (3): 59-60.
8.	徐晓峰, 李明. 23 例膝关节镜手术并发症的分析. 中国医师进修杂志, 2007, 30(14): 64-65.
9.	柴卫兵, 卢宏章, 郑辉, 等. 膝关节镜手术的并发症及其对策. 中国微创外科杂志, 2007, 7(2): 163-164, 176.
10.	王立德. 膝关节镜下手术的并发症及意外. 北京: 中华医学会第十四届骨科学术会议暨第七届 COA 国际学术大会论文汇编, 2012: 165-167.
11.	蒋青, 林共周, 田得祥. 膝关节镜手术并发症及其防治. 中国运动医学杂志, 2000, 19(1): 15-16.
12.	夏林波. 三大类常见膝关节镜手术的并发症防治分析. 高志增, 主编. 外科学(骨外). 南昌: 南昌大学,, 2015.
13.	范国崇. 膝关节镜术后常见并发症分析及治疗. 医学综述, 2009, 15(6): 951-954.
14.	梁学振, 王少山, 魏姗姗. 膝关节镜术后并发症的分析. 实用中西医结合临床, 2014, 14(7): 75-76.
15.	祁志强, 张秉文, 杨建业. 膝关节镜手术并发症临床分析. 临床骨科杂志, 2007, 10(1): 70-71.
16.	张经纬, 蒋垚, 赵金忠, 等. 722 例膝关节镜清理术并发症分析. 中国骨与关节损伤杂志, 2005, 20(9): 592-594.
17.	张益宏, 邵越峰. 关节镜下半月板手术并发症的病因分析及预防处理. 中国现代医生, 2010, (9): 132-133.
18.	王金凤, 孟庆芳. 膝关节镜术后并发症及其护理. 齐齐哈尔医学院学报, 2010, (3): 485-486.
19.	林碧桢. 膝关节镜手术并发症与临床护理对策分析. 医学信息 (下旬刊), 2010, (12): 290.
20.	贺兰英, 姜坤, 林春晓. 膝关节镜术后并发症的预防及护理. 齐鲁护理杂志, 2006, (18): 1810-1811.
21.	蔡芳琳. 膝关节镜手术的常见并发症及预见性护理实践. 医药前沿, 2014, (12): 283-284.
22.	陈露琳, 邹娟. 浅谈膝关节镜术后并发症及预防护理. 医学信息, 2013, (30): 304.
23.	刘挺, 迟晓飞, 于燕. 浅谈膝关节镜手术并发症的原因分析. 中外健康文摘, 2012, (33): 165-166.
24.	徐志宏, 陈东阳, 邱旭升, 等. 1 582 例膝关节镜手术意外及并发症分析. 中国矫形外科杂志, 2010, (6): 444-447.
25.	张建军. 膝关节镜手术并发症临床分析. 中国实用医药, 2009, (34): 45-46.
26.	赵铁军, 单鹏程, 孙钢, 等. 膝骨关节炎关节镜清理术并发症病因分析及对策. 中国骨与关节损伤杂志, 2016, 31(8): 814-816.
27.	林海东, 张燕飞, 刁新清. 膝关节镜手术并发症及其处理. 中国中西医结合外科杂志, 2006, (3): 302.
28.	贾岩波, 梁子红, 任逸众, 等. 关节镜下前交叉韧带重建术后早期并发症的预防及治疗. 中国骨与关节损伤杂志, 2016, (2): 153-155.
29.	崔文, 赵东升. 关节镜手术并发症 5 例分析. 中国误诊学杂志, 2004, (1): 109-110.
30.	郝晓东, 蒋攀峰. 关节镜下半月板手术并发症的分析及对策. 中国保健营养(中旬刊), 2013, (9): 130-131.
31.	茹海凤. 膝关节镜术后并发症的观察及护理. 家庭护士, 2008, (10): 891.
32.	孙志刚, 姜海深, 胡斯乐吐, 等. 膝关节镜术后常见并发症及其应对原则. 赤峰学院学报(自然科学版), 2007, (6): 24.
33.	钟德霞, 席晓颖, 麦桃香. 品管圈活动在预防关节镜下后交叉韧带重建术后并发症的应用价值分析. 中国医学创新, 2016, (24): 83-86.
34.	钭晓帆, 徐晓连. 膝关节镜下交叉韧带重建术后并发症的观察和护理. 浙江医学, 2010, (1): 140-142.
35.	张丽萍. 膝关节镜术后并发症的护理对策及康复指导. 青海医药杂志, 2009, (3): 42-43.
36.	陈娜. 术中护理配合方法对膝关节镜下术中出血量及术后并发症的影响. 国际护理学杂志, 2015, (8): 1051-1053.
37.	魏燕, 司文, 黄英丽. 品管圈在预防关节镜下前交叉韧带重建术后并发症的价值分析. 世界最新医学信息文摘, 2018, 18(72): 323-324.
38.	张凤清, 方军, 秦玉梅, 等. 膝关节镜手术患者并发症的早期预防及护理. 护士进修杂志, 2008, (14): 1315-1317.
39.	韩大伟, 张文涛. 对关节镜下自体半腱肌股薄肌前交叉韧带重建术后并发症的治疗体会. 求医问药(下半月), 2013, (3): 141-142.
40.	张金磊. 经膝关节镜引导小切口内固定术对胫骨平台骨折患者术后膝关节功能及并发症发生率的影响. 现代医用影像学, 2018, (6): 2119-2120.
41.	王佩鑫, 李宏田, 刘建蒙. 无对照二分类资料的 Meta 分析方法及 Stata 实现. 循证医学, 2012, 12(1): 52-55, 64.
42.	Salzler MJ, Lin A, Miller CD, et al. Complications after arthroscopic knee surgery. Am J Sports Med, 2014, 42(2): 292-296.
43.	DeLee, JC. Complications of arthroscopy and arthroscopic surgery:results of a national survey. Committee on Complications of Arthroscopy Association of North America. Arthroscopy, 1985, 1(4): 214-220.
44.	Greene JW, Deshmukh AJ, Cushner FD. Thromboembolic complications in arthroscopic surgery. Sports Med Arthrosc Rev, 2013, 21(2): 69-74.
45.	陈成帷, 潘哲尔, 周也立, 等. 常规止血带下膝关节镜手术后早期深静脉血栓的发生率及危险因素分析. 中国骨伤, 2018, 31(9): 48-53.
46.	Clement RC, Haddix KP, Creighton RA, et al. Risk factors for infection after knee arthroscopy: analysis of 595 083 cases from 3 united states databases. Arthroscopy, 2016, 32(12): 2556-2561.

1. Small, NC. Complications in arthroscopy: the knee and other joints: committee on complications of the Arthroscopy Association of North America. Arthroscopy, 1986, 2(4): 253-258.
2. Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy, 1988, 4(3): 215-221.
3. Hagino T, Ochiai S, Watanabe Y, et al. Complications after arthroscopic knee surgery. Arch Orthop Trauma Surg, 2014, 134(11): 1561-1564.
4. Owens DK, Lohr KN, Atkins D, et al. AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions--agency for healthcare research and quality and the effective health-care program. J Clin Epidemiol, 2010, 63(5): 513-523.
5. 张春礼, 李明全, 范宏斌, 等. 膝关节镜手术并发症及其防治. 中国微创外科杂志, 2003, 3(4): 303-305.
6. 闫长明, 王斌. 630 例膝关节镜手术并发症分析及防治对策. 中国内镜杂志, 2014, 20(3): 294-297.
7. 李晓东, 王远菊, 张之智, 等. 3 760 例膝关节镜手术并发症临床分析及处理. 中国伤残医学, 2013, (3): 59-60.
8. 徐晓峰, 李明. 23 例膝关节镜手术并发症的分析. 中国医师进修杂志, 2007, 30(14): 64-65.
9. 柴卫兵, 卢宏章, 郑辉, 等. 膝关节镜手术的并发症及其对策. 中国微创外科杂志, 2007, 7(2): 163-164, 176.
10. 王立德. 膝关节镜下手术的并发症及意外. 北京: 中华医学会第十四届骨科学术会议暨第七届 COA 国际学术大会论文汇编, 2012: 165-167.
11. 蒋青, 林共周, 田得祥. 膝关节镜手术并发症及其防治. 中国运动医学杂志, 2000, 19(1): 15-16.
12. 夏林波. 三大类常见膝关节镜手术的并发症防治分析. 高志增, 主编. 外科学(骨外). 南昌: 南昌大学,, 2015.
13. 范国崇. 膝关节镜术后常见并发症分析及治疗. 医学综述, 2009, 15(6): 951-954.
14. 梁学振, 王少山, 魏姗姗. 膝关节镜术后并发症的分析. 实用中西医结合临床, 2014, 14(7): 75-76.
15. 祁志强, 张秉文, 杨建业. 膝关节镜手术并发症临床分析. 临床骨科杂志, 2007, 10(1): 70-71.
16. 张经纬, 蒋垚, 赵金忠, 等. 722 例膝关节镜清理术并发症分析. 中国骨与关节损伤杂志, 2005, 20(9): 592-594.
17. 张益宏, 邵越峰. 关节镜下半月板手术并发症的病因分析及预防处理. 中国现代医生, 2010, (9): 132-133.
18. 王金凤, 孟庆芳. 膝关节镜术后并发症及其护理. 齐齐哈尔医学院学报, 2010, (3): 485-486.
19. 林碧桢. 膝关节镜手术并发症与临床护理对策分析. 医学信息 (下旬刊), 2010, (12): 290.
20. 贺兰英, 姜坤, 林春晓. 膝关节镜术后并发症的预防及护理. 齐鲁护理杂志, 2006, (18): 1810-1811.
21. 蔡芳琳. 膝关节镜手术的常见并发症及预见性护理实践. 医药前沿, 2014, (12): 283-284.
22. 陈露琳, 邹娟. 浅谈膝关节镜术后并发症及预防护理. 医学信息, 2013, (30): 304.
23. 刘挺, 迟晓飞, 于燕. 浅谈膝关节镜手术并发症的原因分析. 中外健康文摘, 2012, (33): 165-166.
24. 徐志宏, 陈东阳, 邱旭升, 等. 1 582 例膝关节镜手术意外及并发症分析. 中国矫形外科杂志, 2010, (6): 444-447.
25. 张建军. 膝关节镜手术并发症临床分析. 中国实用医药, 2009, (34): 45-46.
26. 赵铁军, 单鹏程, 孙钢, 等. 膝骨关节炎关节镜清理术并发症病因分析及对策. 中国骨与关节损伤杂志, 2016, 31(8): 814-816.
27. 林海东, 张燕飞, 刁新清. 膝关节镜手术并发症及其处理. 中国中西医结合外科杂志, 2006, (3): 302.
28. 贾岩波, 梁子红, 任逸众, 等. 关节镜下前交叉韧带重建术后早期并发症的预防及治疗. 中国骨与关节损伤杂志, 2016, (2): 153-155.
29. 崔文, 赵东升. 关节镜手术并发症 5 例分析. 中国误诊学杂志, 2004, (1): 109-110.
30. 郝晓东, 蒋攀峰. 关节镜下半月板手术并发症的分析及对策. 中国保健营养(中旬刊), 2013, (9): 130-131.
31. 茹海凤. 膝关节镜术后并发症的观察及护理. 家庭护士, 2008, (10): 891.
32. 孙志刚, 姜海深, 胡斯乐吐, 等. 膝关节镜术后常见并发症及其应对原则. 赤峰学院学报(自然科学版), 2007, (6): 24.
33. 钟德霞, 席晓颖, 麦桃香. 品管圈活动在预防关节镜下后交叉韧带重建术后并发症的应用价值分析. 中国医学创新, 2016, (24): 83-86.
34. 钭晓帆, 徐晓连. 膝关节镜下交叉韧带重建术后并发症的观察和护理. 浙江医学, 2010, (1): 140-142.
35. 张丽萍. 膝关节镜术后并发症的护理对策及康复指导. 青海医药杂志, 2009, (3): 42-43.
36. 陈娜. 术中护理配合方法对膝关节镜下术中出血量及术后并发症的影响. 国际护理学杂志, 2015, (8): 1051-1053.
37. 魏燕, 司文, 黄英丽. 品管圈在预防关节镜下前交叉韧带重建术后并发症的价值分析. 世界最新医学信息文摘, 2018, 18(72): 323-324.
38. 张凤清, 方军, 秦玉梅, 等. 膝关节镜手术患者并发症的早期预防及护理. 护士进修杂志, 2008, (14): 1315-1317.
39. 韩大伟, 张文涛. 对关节镜下自体半腱肌股薄肌前交叉韧带重建术后并发症的治疗体会. 求医问药(下半月), 2013, (3): 141-142.
40. 张金磊. 经膝关节镜引导小切口内固定术对胫骨平台骨折患者术后膝关节功能及并发症发生率的影响. 现代医用影像学, 2018, (6): 2119-2120.
41. 王佩鑫, 李宏田, 刘建蒙. 无对照二分类资料的 Meta 分析方法及 Stata 实现. 循证医学, 2012, 12(1): 52-55, 64.
42. Salzler MJ, Lin A, Miller CD, et al. Complications after arthroscopic knee surgery. Am J Sports Med, 2014, 42(2): 292-296.
43. DeLee, JC. Complications of arthroscopy and arthroscopic surgery:results of a national survey. Committee on Complications of Arthroscopy Association of North America. Arthroscopy, 1985, 1(4): 214-220.
44. Greene JW, Deshmukh AJ, Cushner FD. Thromboembolic complications in arthroscopic surgery. Sports Med Arthrosc Rev, 2013, 21(2): 69-74.
45. 陈成帷, 潘哲尔, 周也立, 等. 常规止血带下膝关节镜手术后早期深静脉血栓的发生率及危险因素分析. 中国骨伤, 2018, 31(9): 48-53.
46. Clement RC, Haddix KP, Creighton RA, et al. Risk factors for infection after knee arthroscopy: analysis of 595 083 cases from 3 united states databases. Arthroscopy, 2016, 32(12): 2556-2561.

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