Complications Study Overview

Complications Study

Knee and Shoulder Arthroscopic Complications (KSAC) Study

Purpose of Study
To establish a data base from which the incidence of acute complications in knee and shoulder arthroscopy can be determined; utilize the data base to determine the factors associated with these complications; and determine the incidence of complications by surgeon demographics

Scope of Project
1. Participants will establish and account with a unique login to a secure web site
2. Demographics will be collected from participating surgeons
3. Participants will report consecutive knee and shoulder arthroscopies for 6 months and each case will be assigned an index number
4. Participants will be emailed every 2 weeks to input cases performed since the previous report period and to report any complications occurring in index cases performed in the previous 6 weeks. This will require 15 reporting periods.
5. A minimum of 150,000 cases will be reported and followed for 6 weeks per case

Participant Requirements
Members of AANA, AOSSM and AAOS will be surveyed via email for qualifications and willingness to participate
1. Must perform minimum of 10 knee and/or shoulder arthroscopies/month
2. Must be willing to input data on consecutive knee and shoulder arthroscopies every 2 weeks for 6 months

Participant (Surgeon) Profile
1. Age
2. Average number of knee scopes/month
3. Average number of shoulder scopes/month
4. Years in practice
5. Type of practice – academic, private or military
6. Arthroscopy and/or Sports medicine fellowship training

Patient Demographics
1. Age
2. Sex
3. Weight and height
4. Current tobacco usage (yes or no)
5. Pre-operative meds (within 4 days of surgery)
    a. Estrogen
    b. LMW Heparin (Lovenox, Fragmin, etc.)
    c. Coumadin
    d. Plavix
    e. ASA
6. Previous thromboembolic disease
7. Diabetes Mellitus
8. Previous surgery on operative extremity
What?_________

Surgical Variables
1. Procedure(s) performed by CPT code
2. Anesthesia type (general, spinal, epidural, local, regional)
3. Pre-emptive analgesia (scalene or femoral block)
4 Use of pre-operative antibiotics?
         Kefzol, Clindamycin, Vancomycin, Levaquin, other_______
5. Positioning (Beach chair or lateral decubitus) – shoulders only
6. Inflow via pump or gravity
7. Tourniquet usage, time, pressure (knees only)
8. Operative time (incision-close)
9. Intra-operative DVT prophylaxis (PAS stockings –well leg in knees and both legs in shoulders)
10. Location of surgery (hospital or surgery center)

Post-operative Variables
1. DVT prophylaxis
    a. LMW heparin
    b. ASA
    c. Coumadin
    d. TED hose
    e. Mechanical compression (PAS stockings or other)
    f. Other _____________
2. Weight-bearing and immobilization status in knee surgery
    a. Immediate WBAT or limited WB (Knees only)
    b. Immobilization or immediate ROM as tolerated (Knees and shoulders)

Complications to be Reported

Intra-operative
1. Instrument breakage (what)
2. Implant failure (suture breakage, anchor pull out, other)
3. Nerve injury (what)
4. Surgical vascular injury (what)
5. Intraoperative MI (fatal or non-fatal)
6. Intraoperatice CVA
7. Intraoperative block complication
Local anesthetic toxicity (seizure)
Other___________________________
8. Wrong-site surgery

Post-operative
1. Thromboembolic disease
    a. DVT (UE or LE)
    b. PE (non-fatal)
2. Wound dehiscence/ non-healing
3. Skin compromise – burns, blisters
4. Infection
    a. Deep
    b. Superficial
5. Hemarthrosis (requiring aspiration, reoperation or affecting post-operative recovery)
6. RSD (CRPS)
7. Complications secondary to intra-operative patient positioning or traction (peroneal nerve neuropraxia, radial nerve neuropraxia, skin compromise, other)
8. Death
   a. MI
   b. CVA
   c. PE (fatal)
9. Post-op anesthesia complications
    a. Persistent neurologic symptoms following blocks (sensory, motor or both) at 2 weeks +/- 6 weeks
    b. Spinal headache

Miscellaneous
1. Reportable arthroscopic cases – shoulder and knee surgeries where greater than 50% of operative time is spent on arthroscopic portion of the procedure
2. Data will be reportable by PDA, laptop and desk-top technology
3. Data will be securely stored and confidentiality strictly enforced