Complications from Treatments
Complications from arthroscopic surgery are rare. The most common is swelling. If this occurs, it will prolong your recovery, but ultimately will resolve and not be a long term problem. Do not take anything with aspirin in it for at least ten days prior to the surgery. Aspirin, or medicines containing aspirin, diminish the ability of blood to clot and can result in excessive bleeding and swelling in the knee after an arthroscopic procedure. Infection, which means pus in the knee, can occur. This is serious and will require re-admission to the hospital, prolonged intravenous antibiotic treatment, and one or more arthroscopies to clean out the knee. Residual stiffness and loss of motion can occur secondary to this complication.
Blood clots in the leg, or thrombo-phlebitis, can occur and will often require admission to the hospital and specific treatment with blood thinners. If the blood clot goes to the lung, it can be life threatening. Anesthesia complications will be discussed by the anesthesia physician, or anesthesiologist. Complications can occur if the cartilage is repaired; these are also rare. Since needles are being pushed through the cartilage and out the sides and back of the knee, punctured nerves and blood vessel can occur.
In the case of a damaged nerve, numbness and/ or hypersensitivity of the skin and partial paralysis of some of the muscles below the knee can occur. Blood vessel damage, in the worst scenario, could result in loss of limb. I have not had any of these complications except occasional numbness and hypersensitivity of the skin, which is usually not a serious problem.
Reflex sympathetic dystrophy is the medical term for an extremely rare complication following injury and/or surgery on the extremities. It is an abnormal response to injury and/or surgery which involves the small nerves (sympathetic nerves) which supply the blood vessels and sweat glands. It is painful, and the symptoms can involve the whole limb. They include hypersensitivity, increased sweating, color change, and others. Once diagnosed, it can usually be successfully treated, but this can be long, difficult and frustrating for both the patient and the physician.
The consequences of partial removal of a torn cartilage are not completely known. The most common long term problem is the development of arthritis on the side from which the cartilage was removed. This typically may occur many years later. I think it is less common when only a portion of the cartilage has to be removed as opposed to having to remove all the cartilage. Leaving the torn cartilage however, is not usually a viable option.
In addition to continuing and usually disabling pain, joint surface damage or arthritis will often develop. This is the reason that I do think if it is feasible, a repair should be carried out when conditions are favorable. What you can expect from having a partial removal should be a knee that functions better and to get rid of most of your symptoms. A repair that is successful and without complication and does not re-tear should be nearly normal. The presence of arthritis or the development of it later will cause developing or continued pain with swelling in the knee. Sometimes, the arthritic situation can be improved a bit by arthroscopy, but never cured.
After surgery, the hope is that your knee will be improved, and significantly so. Even under the best of circumstances, you should expect at least some residual symptoms such as occasional clicks, hopefully non-painful pops, slight swelling, weather change pain, and the like. Arthroscopic surgery cannot restore a knee or other joint to complete normality.
*The information contained here is intended to help you and your families/caretakers better understand a particular diagnosis and/or the treatment options available. If you have any questions after reading this, please don’t hesitate to contact Dr. Longobardi’s office at 201.343.1717 for a further explanation.
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