Arush Patel1, Brent Ogawa, Timothy Charlton, David Thordarson. 1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo St Suite 2000, Los Angeles, CA 90033, USA.
Abstract
BACKGROUND: The use of venous thromboembolism prophylaxis after an Achilles rupture is controversial. The rates of reported deep vein thrombosis (DVT) range from 6.3% to 34%. There is no agreement regarding prophylactic therapy after an Achilles tendon rupture. QUESTIONS/PURPOSES: We determined the overall risk of DVT and pulmonary embolism (PE) after an Achilles tendon rupture and identified potential risk factors including surgery. PATIENTS AND METHODS: We retrospectively reviewed a large healthcare management organization database and identified 1172 patients who had Achilles tendon ruptures. None of the patients routinely received anticoagulation. Patients were stratified into surgical versus nonsurgical group, age older than 40 years, history of congestive heart failure, previous history of DVT or PE, and BMI greater than 30. A patient was considered to have symptomatic DVT or PE related to the Achilles tendon rupture if diagnosed within 3 months from the injury or surgery. We used a multivariable analysis to identify risk factors. RESULTS: The overall rates for DVT and PE after Achilles tendon ruptures were 0.43% and 0.34%, respectively. Age older than 40 years, congestive heart failure, history of DVT or PE, obesity, and whether a patient had surgery did not predict occurrence of DVT or PE. CONCLUSION: We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.
BACKGROUND: The use of venous thromboembolism prophylaxis after an Achilles rupture is controversial. The rates of reported deep vein thrombosis (DVT) range from 6.3% to 34%. There is no agreement regarding prophylactic therapy after an Achilles tendon rupture. QUESTIONS/PURPOSES: We determined the overall risk of DVT and pulmonary embolism (PE) after an Achilles tendon rupture and identified potential risk factors including surgery. PATIENTS AND METHODS: We retrospectively reviewed a large healthcare management organization database and identified 1172 patients who had Achilles tendon ruptures. None of the patients routinely received anticoagulation. Patients were stratified into surgical versus nonsurgical group, age older than 40 years, history of congestive heart failure, previous history of DVT or PE, and BMI greater than 30. A patient was considered to have symptomatic DVT or PE related to the Achilles tendon rupture if diagnosed within 3 months from the injury or surgery. We used a multivariable analysis to identify risk factors. RESULTS: The overall rates for DVT and PE after Achilles tendon ruptures were 0.43% and 0.34%, respectively. Age older than 40 years, congestive heart failure, history of DVT or PE, obesity, and whether a patient had surgery did not predict occurrence of DVT or PE. CONCLUSION: We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.
Authors: M S Mizel; H T Temple; J D Michelson; R G Alvarez; T O Clanton; C C Frey; A P Gegenheimer; S R Hurwitz; L D Lutter; M G Mankey; R A Mann; R A Miller; E G Richardson; L C Schon; F M Thompson; M L Yodlowski Journal: Clin Orthop Relat Res Date: 1998-03 Impact factor: 4.176
Authors: Lasse J Lapidus; Stefan Rosfors; Sari Ponzer; Catharina Levander; Anders Elvin; Gerd Lärfars; Edin de Bri Journal: J Orthop Trauma Date: 2007-01 Impact factor: 2.512
Authors: Abdullah Pandor; Daniel Horner; Sarah Davis; Steve Goodacre; John W Stevens; Mark Clowes; Beverley J Hunt; Tim Nokes; Jonathan Keenan; Kerstin de Wit Journal: Health Technol Assess Date: 2019-12 Impact factor: 4.014
Authors: M R Carmont; C Heaver; A Pradhan; O Mei-Dan; K Gravare Silbernagel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-02-02 Impact factor: 4.342
Authors: Dimitrios A Flevas; Panayiotis D Megaloikonomos; Leonidas Dimopoulos; Evanthia Mitsiokapa; Panayiotis Koulouvaris; Andreas F Mavrogenis Journal: EFORT Open Rev Date: 2018-04-27
Authors: Kristoffer Weisskirchner Barfod; Emil Graakjær Nielsen; Beth Hærsted Olsen; Pablo Gustavo Vinicoff; Anders Troelsen; Per Holmich Journal: Orthop J Sports Med Date: 2020-04-28
Authors: Brad Meulenkamp; Taylor Woolnough; Wei Cheng; Risa Shorr; Dawn Stacey; Megan Richards; Arnav Gupta; Dean Fergusson; Ian D Graham Journal: Clin Orthop Relat Res Date: 2021-10-01 Impact factor: 4.755