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Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France

  • SPORTS TRAUMATOLOGY
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The main objective of this study was to identify the epidemiological characteristics of litigation following arthroscopic procedures, performed in private practice and public hospitals in France. The secondary objective was to establish a risk profile for medical malpractice lawsuits after arthroscopic surgery.

Methods

All court decisions related to arthroscopic surgery between 1994 and 2020 were collected and reviewed cases from the two main French legal databases (Legifrance and Doctrine). Data were retrospectively collected and included: gender, joint and defendant’s specialty involved, reason behind the lawsuit, initial indication and the type of arthroscopic procedure performed. The final verdicts as well as the indemnity awarded to the plaintiff (if any) were recorded.

Results

One-hundred eighty cases met the inclusion criteria of the study and were analyzed: 58 cases were before administrative courts and 122 were before civil courts. An orthopaedic surgeon was involved alone or in solidum in 45.6% of cases (82/180), followed by anesthesiologists in 5.6% (10/180). The private surgery center or public hospital were implicated in 63.9% (115/180) of cases. The 2 most common joints involved in litigation following arthroscopic surgery were the knee (82.2%, n = 148) and the shoulder (11.1%, n = 20). The main reasons behind the lawsuit were related to postoperative infection in 78/180 cases and to a musculoskeletal complication in 45/180 cases (25%). A failure to inform was also reported in 34/180 cases (18.9%). Of the 180 cases, 122 cases (67.8%) resulted in a verdict for the plaintiff. The average indemnity award for the plaintiff was 77.984 euros [2.282–1.117.667]. A verdict for the plaintiff was significantly associated with postoperative infection or a wrong-side surgery, while technical error and musculoskeletal complications were more significantly likely to result in a verdict in favor of the defendant (p = 0.003).

Conclusion

This study evaluated and mapped lawsuits following after arthroscopic surgery in France over a period of more than 20 years. The main joint involved in lawsuits was knee. The main causes of lawsuits following arthroscopic surgery were related to postoperative infection, musculoskeletal complications and failure to inform.

Level of Evidence

Level IV.

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Acknowledgements

The authors thank the attorneys at law Dana Leib (New York Bar) and Barbara Teissier du Cros (Paris Bar) for their kind help.

Funding

No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157, Le Chesnay, France

    Charles Pioger, Christophe Jacquet, Alexandre Abitan, Philippe Boisrenoult & Nicolas Pujol

  2. Department of Orthopaedic Surgery, Lariboisiere Hospital University, Paris 7 University, Paris, France

    Guillaume-Anthony Odri

  3. Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St. Marguerite Hospital, Marseille, France

    Christophe Jacquet & Matthieu Ollivier

  4. Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hopital Privé Jean-Mermoz, Lyon, France

    Bertrand Sonnery-Cottet

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  1. Charles Pioger
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Contributions

CP has made substantial contributions to conception, study design, acquisition/interpretation of data and in drafting the manuscript. CJ and AA have made substantial contributions to acquisition of data. GO was in charge of the statistical analysis. MO, PB, BSC and NP have been involved in drafting or revising the manuscript critically. Each author has given final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Charles Pioger.

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Conflict of interest

CP, CJ, AA, PB and GO have nothing to disclose. MO is educational consultant for Stryker and Newclip. BSC is educational consultant and receives royalties from Arthrex. NP is occasional educational consultant for Smith&Nephew, Lima, ZimmerBiomet, Stryker, outside the scope of this work.

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No ethical approval was need for this study.

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Pioger, C., Jacquet, C., Abitan, A. et al. Litigation in arthroscopic surgery: a 20-year analysis of legal actions in France. Knee Surg Sports Traumatol Arthrosc 29, 1651–1658 (2021). https://doi.org/10.1007/s00167-020-06182-3

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  • DOI: https://doi.org/10.1007/s00167-020-06182-3

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