Background In the literature, factors associated with postoperative venous thromboembolisms (VTEs) after anterior cruciate ligament reconstruction (ACLR) are limited. This study aimed to investigate the incidence of venous thromboembolisms (VTEs) after anterior cruciate ligament reconstruction (ACLR) and to identify risk and predictive factors for VTEs. Methods This retrospective study included 136 patients who underwent arthroscopic ACLR with mechanical prophylaxis between April 2012 and July 2022. Contrast-enhanced computed tomography (CT) was applied to detect VTEs comprising deep venous thromboses and pulmonary embolisms 7 days after surgery. Data including age, sex, body mass index, concomitant treatments, graft types, smoking status, operative and tourniquet times, postoperative D-dimer levels, and other laboratory test results, were collected for analyses. The incidence of radiographically confirmed VTEs and the associated risk factors, such as age, sex, body mass index, concomitant treatments, graft types, smoking status, operative and tourniquet times, postoperative D-dimer levels, and other laboratory test results, were analyzed. Results The overall incidence of radiographic VTEs was 11.0% (15 cases) in 136 patients. There was one symptomatic patient who had Homan’s sign. Multivariable analysis indicated that postoperative D-dimer level was an independent factor related to a radiographic VTE after ACLR, although there was no association between radiographic VTEs and preoperative status or operation status. The optimal cutoff value for postoperative D-dimer level was 2.8 μg/ml according to the receiver operating characteristic curve analysis, with a sensitivity of 80.0% and specificity of 83.5%. Conclusion The incidence of ACLR-associated radiographical VTEs (deep venous thrombosis and pulmonary embolism) under mechanical prophylaxis was 11.0% in this study. An elevated D-dimer level at 7 days after surgery is an independent predictor of VTE in patients undergoing ACLR. The postoperative D-dimer level is a more reliable marker for identifying VTE in patients who underwent ACLR.

Physical inactivity contributes significantly to poor health and the onset of disease. Physical inactivity is also associated with severe economic burdens. Japan’s Ministry of Health, Labor and Welfare (MHLW) cites the provision of various health promotion incentives aimed at health-indifferent groups, which are made up of individuals less interested in health promotion. This study investigated the relationship between medical costs and a pedometer-based walking program providing monetary incentives based on daily step counts. The study sample included 16,816 citizens aged 40–75 years who lived in Takaishi City and were enrolled in the NIH from October 2016 to March 2018. The results of the ordinal logistic regression analysis showed that participation in a walking promotion program with an HPFI was correlated with a reduction in healthcare costs over 1 year in a sample of Takaishi City residents. In fact, there was a difference of 67,077 yen in the average medical cost per person per year between the walking and control groups. With 1,923 walking group participants, the total medical cost reduction was predicted to be at least 12,898,904 yen. In this study, we evaluated the effectiveness of a walking promotion program with incentives. With program context differing widely from region to region and country to country, future investigations are needed to inform the selection of appropriate incentive schemes for programs offered in other regions and countries.