Complications in Knee and Shoulder Surgery : Management and Treatment Options for the Sports Medicine Orthopedist

Any surgical intervention has potential risks and complications. Some complications are avoidable and some are not. Arthrofibrosis or stiffness may take place in the best of hands, and infection may surface postoperatively even in the most sterile operating room. How one deals with complications truly tests the skill of the surgeon. Keeping calm and focussed on the issues in the midst of an intraoperative complication will be facilitated by having an algorithmic approach. Complications in Knee and Shoulder Surgery is designed as a reference tool and a roadmap for the sports medicine orthopedist to minimize complications in knee and shoulder surgery. By understanding the functional anatomy at risk, proper surgical set up, proper equipment, and proper patient selection, a preventative approach to complications can be instituted. The authors of these chapters are leaders in orthopedic sports medicine and reveal their techniques for dealing with intraoperative complications, increasing the surgeon's awareness of potential complications and providing advice to avoid and treat these problems effectively and rapidly should they arise. Written for: Practicing clinicians, orthopaedic knee and shoulder surgeons “To Err is Human...” Alexander Pope Any surgical intervention has potential risks and complications. This book is designed as a reference tool and a roadmap for the sports medicine orthopedist to minimize the complications in knee and shoulder surgery. Some complications are avoidable; some are not. By understanding the functional anatomy at risk, proper surgical setup, proper equipment, and proper patient selection, a preventative approach to complications can be instituted. The authors of these chapters represent leaders in orthopedic sports medicine and have provided novel methods for dealing with intraoperative complications and si- ations that can occur in the midst of a “routine” arthroscopic reconstruction. In d- cussing these issues, we hope to raise the surgeon's awareness of potential complications and to provide wisdom and advice to properly avoid and treat these problems should they arise. How one deals with complications truly tests the mettle of the surgeon. Keeping one's “cool” in the midst of an intraoperative complication will be facilitated by h- ing an algorithmic approach. We hope that this book will improve your outcome should these problems occur. Some complications are unavoidable. Arthro brosis or stiffness may take place in the best of hands. Infection may surface postoperatively in the most sterile OR. We provide you with the background to confront these challenges. A list of ten “Pearls” are offered at the beginning of most chapters as a quick reference card. Front Matter....Pages i-xiii Avoiding and Managing Complications in Meniscus Repair....Pages 1-18 Avoiding and Managing Complications in Meniscus Transplantation....Pages 19-36 Avoiding and Managing Complications in Cartilage Restoration Surgery....Pages 37-51 Avoiding and Managing Complications in ACL Reconstruction....Pages 53-74 Avoiding and Managing Complications in PCL Reconstruction....Pages 75-90 Avoiding and Managing Complications of Collateral Ligament Surgery of the Knee....Pages 91-114 Avoiding and Managing Complications in Osteotomies of the Knee....Pages 115-132 Avoiding and Managing Complications in Patella Surgery....Pages 133-163 Avoiding and Managing Complications Associated with Arthroscopic Knee Surgery: Miscellaneous Knee Conditions....Pages 165-173 Avoiding and Managing Complications in Shoulder Labral Repair....Pages 175-187 Avoiding and Managing Complications for Shoulder Superior Labrum (SLAP) Repair....Pages 189-205 Avoiding and Managing Complications of Arthroscopic Biceps Tenodesis....Pages 207-223 Avoiding and Managing Complications of Arthroscopic Rotator Cuff Repair....Pages 225-244 Avoiding and Managing Complications of Surgery of the Acromioclavicular Joint....Pages 245-264 Complications of Arthroscopic Shoulder Surgery: Miscellaneous Shoulder Conditions....Pages 265-272 Back Matter....Pages 273-280 Preface 6 Contents 7 Contributors 9 1. Avoiding and Managing Complications in Meniscus Repair 12 2. Avoiding and Managing Complications in MeniscusTransplantation 30 3. Avoiding and Managing Complications in Cartilage Restoration Surgery 48 4. Avoiding and Managing Complications in ACL Reconstruction 63 5. Avoiding and Managing Complications in PCL Reconstruction 85 6. Avoiding and Managing Complications of Collateral Ligament Surgery of the Knee 101 7. Avoiding and Managing Complications in Osteotomies of the Knee 125 8. Avoiding and Managing Complications in Patella Surgery 143 9. Avoiding and Managing Complications Associated with Arthroscopic Knee Surgery: Miscellaneous Knee Conditions 174 10. Avoiding and Managing Complications in Shoulder Labral Repair 183 11. Avoiding and Managing Complications for Shoulder SuperiorLabrum (SLAP) Repair 196 12. Avoiding and Managing Complications of ArthroscopicBiceps Tenodesis 213 13. Avoiding and Managing Complications of ArthroscopicRotator Cuff Repair 230 14. Avoiding and Managing Complications of Surgeryof the Acromioclavicular Joint 250 15. Complications of Arthroscopic Shoulder Surgery:Miscellaneous Shoulder Conditions 270 Index 278 With the explosion of the baby boom and ensuing interest in physical fitness there has been a glut of sports injuries. Newer surgical techniques have developed and are developing to treat these injuries. Inevitably, complications arise with these procedures that the orthopedic surgeon must confront. Complications in Knee and Shoulder Surgery will provide a resource for these surgeons