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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2006 February;57(1):5-10
Complications of shoulder arthroscopy
Valente A., Quaglia F., Ravera R.
Clinica Ortopedica Dipartimento di Scienze Cliniche e Biologiche Università degli Studi di Torino Ospedale S. Luigi Gonzaga, Orbassano (TO)
Aim. A survey of the literature on complications associated with arthroscopic shoulder surgery is made trying to define their incidence and management.
Methods. Our research was carried out on PubMed and OVID-Medline databases. Key words used were: “complications of shoulder arthroscopy”, “shoulder arthroscopy”, “rotator cuff” and “intraoperative complications”. The limits used were: English language, years 1980-2005 and human. In this way we found 54 articles, but considered relevant only 29 articles: 14 case reports, 8 journal articles, 5 reviews, 1 case series and 1 prospective cohort study.
Results. Complications of shoulder arthroscopy reported in the literature were: portal bleeding, chondral and rotator cuff iatrogenic lesions, neurologic injuries (transient or permanent), vascular injuries, infections, frozen shoulder, severe postoperative pain, airway obstruction, phrenic nerve palsy, pleural puncture, subcutaneous emphysema, pneumothorax and pneumomediastinum, hematomas and fractures. These complications were related to shoulder arthroscopy, but there were also complications related to general and locoregional anaesthesia.
Conclusion. The rate of complications in shoulder arthroscopy reported in the literature was very various; however, it was considered low. In order to avoid complications, a correct intraoperative positioning of the patients is very important, as well as to perform correct hemostasis, to avoid too much traction of the patient’s arm, to value patient’s risk factors and thus to perform an appropriate prophylaxis. Moreover, it is important to recognize and to opportunely treat complications that could be dangerous for the patient’s life.