Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleIncidence and Risk Factor Analysis of Symptomatic Venous Thromboembolism After Knee Arthroscopy
Section snippets
Methods
Patients were retrospectively identified from a comprehensive surgical database at our institution based on International Classification of Diseases, Ninth Revision10 procedural codes for various arthroscopic procedures of the knee performed between March 23, 1988, and July 17, 2008 (Table 1), and institutional review board approval was obtained. Beginning in 2009, the prophylaxis protocol significantly changed, with the adoption of more rigorous guidelines for high-risk patients. When the
Results
Of the 12,595 knee arthroscopies performed during the study period, 43 cases of VTEs (35 DVTs, 5 PEs, and 3 DVTs that progressed to PEs) occurred, resulting in an incidence of 0.30% (95% CI, 0.22% to 0.41%) for DVT, 0.06% (95% CI, 0.03% to 0.12%) for PE, and 0.34% (95% CI, 0.25% to 0.46%) for VTEs overall. The incidence rate of VTEs was similar among each of the specific arthroscopic procedures (Table 1).
The mean time to VTEs after surgery was 10.3 days (range, 2 to 25 days). Twenty-three
Discussion
In this study we reviewed cases of symptomatic VTEs after 12,595 knee arthroscopies at a single institution and found a low rate of symptomatic VTEs after knee arthroscopy and arthroscopy-assisted procedures of 0.34%. In addition, a history of malignancy, a history of VTEs, and the presence of multiple risk factors were associated with a significant increase in the incidence of VTEs. Although knee arthroscopy is common, data are still lacking on the incidence and risk factors for thromboembolic
Conclusions
In this study, symptomatic VTEs were rare and occurred infrequently (0.34%; 95% CI, 0.25% to 0.46%) after knee arthroscopy and arthroscopy-assisted cases in the absence of routine chemoprophylaxis. Patients with a history of VTEs, a history of malignancy, or 2 or more classic risk factors are at increased risk of VTEs after knee arthroscopy, and chemoprophylaxis should be considered in these select patients.
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The authors report that they have no conflicts of interest in the authorship and publication of this article.