Affiliation:
1. Department of Orthopedics & Rehabilitation University of Iowa Iowa City Iowa USA
2. Department of Orthopaedics & Rehabilitation University of Wisconsin‐Madison Madison Wisconsin USA
3. Sports and Performance Medicine, Swedish Medical Center, Seattle Washington USA
4. Departments of Orthopaedics and Radiology Essentia Health Duluth Minnesota USA
5. Department of Orthopedics and Physical Medicine and Rehabilitation Emory University Atlanta Georgia USA
6. Department of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
7. Elite Sports Performance Medicine Seattle Washington USA
8. Department of Orthopedic Surgery, Sports Medicine Division Mayo Clinic Rochester Minnesota USA
9. Department of Physical Medicine and Rehabilitation Mayo Clinic Rochester Minnesota USA
10. Department of Physical Therapy and Rehabilitation Science University of Iowa Iowa City Iowa USA
Abstract
ObjectivesTo 1) determine the types and frequency of complications within 3 months following ultrasound‐guided surgical procedures, and 2) identify any patient demographics, co‐morbidities, or procedural characteristics that were associated with an increased risk of complications.MethodsA retrospective chart review was performed at six Sports Medicine clinics across the United States. The Clavien‐Dindo classification was used to categorize procedural complications on a 5‐point scale from 1, representing any deviation in post‐procedure care without requiring pharmacological or invasive treatment to 5, representing death. Generalized Estimating Equations for binomial outcomes with a logit link were used to estimate the overall and procedure‐specific 3‐month complication rates.ResultsAmong 1902 patients, 8.1% (n = 154) had diabetes and 6.3% (n = 119) were current smokers. The analysis included 2,369 procedures, which were performed in either the upper extremity (44.1%, n = 1045) or lower extremity (55.2%, n = 1308) regions. The most common procedure was ultrasound‐guided tenotomy (69.9%, n = 1655). Additional procedures included, trigger finger release (13.1%, n = 310), tendon scraping (8.0%, n = 189), carpal tunnel release (5.4%, n = 128), soft tissue release (2.1%, n = 50), and compartment fasciotomy (1.6%, n = 37). Overall, there was a complication rate of 1.2% (n = 29 complications; 95% CI: 0.8–1.7%). Individual procedures had complication rates that ranged from 0 to 2.7%. There were 13 Grade I complications in 13 patients, 12 Grade II complications in 10 patients, 4 Grade III complications in 4 patients, and 0 Grade IV or V complications. No associations between complication risk and any patient demographics (age, sex, BMI), co‐morbidities (diabetes, smoker), or procedure characteristics (type, region) were identified.ConclusionThis retrospective review provides an evidence‐based estimate supporting the low level of risk associated with ultrasound‐guided surgical procedures for patients from a variety of geographical settings who are seeking care at private and academic‐affiliated clinics.
Funder
American Medical Society for Sports Medicine
Subject
Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology