Article

OBJECTIVE: To examine the reporting of lower limb neuropathy within 90 days of
surgery for patients undergoing hip arthroplasty, knee arthroplasty, or knee
arthroscopy. DESIGN: This was a retrospective study using data from the 1998
MarketScan Commercial Claims and Encounter Database (The MEDSTAT Group) to
identify lower limb neuropathy after these surgeries. The sample was selected
within the first 9 months of 1998 using International Classification of Diseases,
9th Revision (ICD-9), and Current Procedural Terminology (CPT) codes for hip and
knee surgical procedures. Lower limb nerve injuries as determined by ICD-9 codes
within 90 days postsurgery were the main outcome measures.
The influence of
diabetes on the rates of nerve injuries after surgery was also examined. RESULTS:
A total of 14,979 patients underwent these surgical procedures, 10 of whom were
reported to have sustained a nerve injury postsurgery (0.07%). The sample
comprised mainly men (53.1%), and the largest groups consisted of those aged
45-54 yrs (27.0%) and 55-64 yrs (27.7%). Nerve injury occurred at a rate of 0.03%
after hip arthroplasty, 0.01% after knee arthroplasty, and 0.02% within 3 mos of
arthroscopic knee surgery. Overall, nerve injuries were two times more prevalent
in the diabetic vs. nondiabetic population (0.11% vs. 0.06%); however, this
difference did not meet conventional levels of statistical significance. Specific
to knee arthroplasty, there were 10-fold differences in nerve injury rates
between diabetic and nondiabetic patients, 0.11% vs. 0.01%, respectively (P <or=
0.01), although the overall risks were small. CONCLUSIONS: Nerve injuries after
hip and knee arthroplasty and knee arthroscopy were rare in a large population of
patients younger than 65 yrs. Although the overall rates were low, there was an
increased occurrence of nerve injuries in the diabetic population. This
information is useful when counseling patients and benchmarking surgical
complication rates.

Langue : ANGLAIS