Thromboprophylaxis in routine arthroscopy of knee

Abstract

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.

A Prospective Assessment of Knee Arthroscopy Skills Between Medical Students and Residents—Simulator Exercises for Partial Meniscectomy and Analysis of Learning Curves

“…This will result in a benefit for the patient, such as shorter anesthesia duration, reduced risk of infection, as well as a lesser danger for the incorporation of irrigation fluid used in the context of arthroscopy. [27][28][29] In conclusion, our results demonstrate the usefulness of an arthroscopy training simulator as an important tool for the improvement of surgical and arthroscopic skills in orthopedic resident surgeons and in medical students. Our study shows a fast (steep) learning curve for orthopedic residents and medical students undergoing a standardized training program on a validated virtual reality-based arthroscopy knee training simulator.…”

CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey

“…Even amongst those that did receive an e-mail, not all had opened it, and of those who did, not all accessed the survey link. Arguably, the 11% response rate and majority academic surgeons may not truly reflect the thinking of the entire COA but is comparable to several recent survey publications surveying COA members (Abouali et al 2013 ; Almeida 2000 ; Khan et al 2013 ; Pally and Kreder 2013 ; Tam et al 2006 ). This is also consistent with response rates traditionally from surveys on surgeons, which range from 15-27% (Almeida 2000 ; Khalily et al 2000 ; Matarasso et al 2000 ).…”

Venous Thromboembolism Prophylaxis in Arthroscopic Surgery

“…[16] W sy tu acji gdy cho ry jest ob cią żo ny czyn ni ka mi ry zy ka nie wol no do pu ścić do je go od wod nie nia do póki nie bę dzie to kli nicz nie uza sad nio ne oraz uru cho mić cho re go naj szyb ciej jak bę dzie to mo żli we. Na le ży wyklu czyć ja kie kol wiek sto so wa nie le ków prze ciw płyt kowych, w tym kwa su ace ty lo sa li cy lo we go, ja ko pro fi lakty ki za krze pi cy [16,[20][21][22][23]. Mo żna rów nież roz wa żyć cza so we za sto so wa nie fil trów do ży ły głów nej dol nej u pa cjen tów z bar dzo wy so kim ry zy kiem wy stą pie nia za krze pi cy oraz tam, gdzie prze ciw wska za na jest pro filak ty ka me cha nicz na i far ma ko lo gicz na [16,24,25].…”

“…They should also be mobilised as soon as possible. Neither acetylsalicylic acid nor any other antiplatelet agents should be regarded as thrombosis prophylaxis [16,[20][21][22][23]. Temporary in ferior vena cava filters may be considered in pa tients who are at very high risk of thrombosis and in those for whom mechanical and pharmacological prophylaxis is con traindicated [16,24,25].…”