Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery

Michot, Marc; Conen, D; Holtz, Daniel; Erni, Daniel; Zumstein, M. D.; Ruflin, G.; Renner, N

doi:10.1053/jars.2002.30013

Cited by 124 publications

(55 citation statements)

References 28 publications

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“…Several studies have compared the rates of DVT in patients who have received DVT prophylaxis after arthroscopic knee surgery to those who did not. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

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Rates of Deep Venous Thrombosis and Pulmonary Embolus After Anterior Cruciate Ligament Reconstruction

et al. 2015

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Context:Venous thromboembolic (VTE) disease is thought to be an uncommon but serious problem after anterior cruciate ligament (ACL) reconstruction. Rates of VTE after ACL reconstruction are not well documented.Objective:To determine the rates of deep vein thrombosis (DVT) and symptomatic pulmonary emboli (PE) after ACL reconstruction.Data Sources:Five publicly available databases (PubMed, Cochrane Database of Systematic Reviews, Scopus, Embase, and CINAHL Complete) were utilized.Study Selection:All studies that screened patients for DVT and reported rates of DVT and PE after ACL reconstruction were eligible for inclusion. Level 5 evidence, cadaver, biomechanical, and basic science studies; studies reporting only multiligament reconstruction outcomes; studies where rates of DVT and PE could not be separated out from patients undergoing other types of arthroscopic knee procedures; and classification studies were excluded.Study Design:Systematic review.Level of Evidence:Level 4.Data Extraction:All study, subject, and surgical data were analyzed. Descriptive statistics were calculated.Results:Six studies met the inclusion criteria, with a mean Modified Colman Methodology Score of 30 ± 8.22. A total of 692 patients (488 men [70.5%]; mean age, 31.6 ± 2.82 years; mean follow-up, 7 ± 18.4 months) underwent ACL reconstruction using either semitendinosus-gracilis autograft (77.6%), bone–patellar tendon–bone (BTB) autograft (22%), or allograft (0.4%). No patient received postoperative pharmacological anticoagulation. Fifty-eight patients (8.4%) had a DVT (81% below knee and 19% above knee), while only 1 patient (0.2%) had a symptomatic PE. When reported, 27% of DVT episodes were symptomatic.Conclusion:The rate of DVT after ACL reconstruction in patients who did not receive postoperative pharmacological anticoagulation is 8.4%, while the rate of symptomatic PE is 0.2%. Of the DVT episodes that occurred, 73% were asymptomatic.

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“…Several studies have compared the rates of DVT in patients who have received DVT prophylaxis after arthroscopic knee surgery to those who did not. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

“…Michot et al 21 evaluated 218 patients who underwent arthroscopic knee surgery and randomized them to LMWH or no prophylaxis. More patients in the LMWH group had minor bleeds postoperatively (12% vs 6%).…”

Section: Discussionmentioning

confidence: 99%

Rates of Deep Venous Thrombosis and Pulmonary Embolus After Anterior Cruciate Ligament Reconstruction

et al. 2015

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“…Previous studies were often performed retrospectively, poor diagnostic tests were used, and studies were often biased 4. As a result, controversy has surrounded the use of thromboprophylaxis in routine arthroscopy of the knee.…”

Section: Introductionmentioning

confidence: 99%

Thromboprophylaxis in routine arthroscopy of knee

Abouali

Farrokhyar

Peterson

et al. 2013

IJOO

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Background:Thromboprophylaxis in arthroscopy is controversial. Recent literature has shown variable rates of deep vein thrombosis following routine arthroscopic knee surgery; however, it is unknown if current practice reflects the literature. We have conducted a cross sectional survey to provide insight into the practice patterns perceived risks, benefits and barrier in the use of thromboprophylaxis.Materials and Methods:A 19 item survey was created regarding surgeons' use of thromboprophylaxis in their patients undergoing routine knee arthroscopy. E-mail surveys were sent out to members of the Canadian Orthopaedic Association.Results:Seventy-seven responses were obtained; of which 58.2% (n=45) of surgeons stated that they had a clinical interest in sports medicine, and 37.3% (n=29) had completed a fellowship in sports medicine or arthroscopy. Fifty five surgeons (71.6%) performed more than 40 arthroscopies per year. Prolonged surgical time was the only risk factor that would significantly increase their use of prophylaxis. Practice patterns surrounding the use of thromboprophylaxis were otherwise quite variable.Conclusions:Our survey reveals that opinions and practice patterns surrounding the use of thromboprophylaxis following routine knee arthroscopy are diverse. This survey points out the need for larger well designed studies for concise guidelines.

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“…[19] Some authors have reported that LMWH is an appropriate anticoagulant for decreasing the DVT rate after arthroscopic surgery. [4,6,14] PCL reconstruction is more invasive than ACL reconstruction. The knee must be repeatedly flexed and extended to allow the tendon to pass through the tunnel, which can cause extensive tissue damage around the knee and increase the opportunity for the formation of DVT.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of deep venous thrombosis following arthroscopic posterior cruciate ligament reconstruction

Chen

Rong

et al. 2017

Medicine

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The objective of this study was to identify the incidence and associated risk factors for deep venous thrombosis (DVT) after arthroscopic posterior cruciate ligament (PCL) reconstruction.This study included 128 patients who underwent arthroscopic PCL reconstruction. Venography was performed on the operated leg 3 days postoperatively. The patients were divided into 2 groups based on whether they had DVT. A correlation analysis was performed to determine the factors associated with DVT.Of all the 128 patients, 28 patients (21.9%) developed DVT, with 4 (3.1%) in a proximal location. Significant differences were found in the mean age, time of application of tourniquet, mean VAS scores, mean d-dimer level, mean cholesterol level, and various surgical procedures in patients with DVT compared with those without DVT. DVT is difficult to diagnose solely based on clinical symptoms.The incidence of DVT was 21.9% in patients who underwent arthroscopic PCL reconstruction. The rate of asymptomatic clots in the calf region was rather high after PCL reconstruction, and the rate of proximal clots was 4%. Older age, longer durations of tourniquet application, higher VAS scores and D-dimer levels, and complex surgical procedures were all substantial risk factors for DVT after PCL reconstruction. The treatment of DVT with batroxobin and anticoagulants was effective and safe.

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Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery

Cited by 124 publications

References 28 publications

Rates of Deep Venous Thrombosis and Pulmonary Embolus After Anterior Cruciate Ligament Reconstruction

Rates of Deep Venous Thrombosis and Pulmonary Embolus After Anterior Cruciate Ligament Reconstruction

Thromboprophylaxis in routine arthroscopy of knee

Incidence and risk factors of deep venous thrombosis following arthroscopic posterior cruciate ligament reconstruction

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