PURPOSE: To (1) determine the incidence of symptomatic venous thromboembolic events (VTEs) after knee arthroscopy and arthroscopy-assisted procedures at a single institution and (2) determine associated risk factors for VTEs in these patients. METHODS: The records of patients who underwent knee arthroscopy at a single institution between 1988 and 2008 were reviewed. Chemoprophylaxis was not routinely used. Confirmed VTEs occurring within 4 weeks after the index arthroscopy procedure were included. A 2:1 matched control group was generated to include patients in whom knee arthroscopy was performed by the same surgeon either on the same day or immediately before each case resulting in a VTE. Preoperative and perioperative data were collected with respect to demographic data, medical history, medications, and surgical and anesthesia data. Univariate and multivariate analyses were performed. RESULTS: During the study period, 12,595 patients underwent knee arthroscopy. Among these patients, 43 cases of VTEs (35 deep venous thromboses [DVTs], 5 pulmonary embolisms [PEs], and 3 DVTs that progressed to PEs) occurred, resulting in an incidence of 0.30% (95% confidence interval [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. Factors associated with an elevated risk of symptomatic postoperative VTEs included a history of malignancy (P = .01; odds ratio [OR], 6.3), a history of VTEs (P = .02; OR, 5.2), or the presence of more than 2 classic risk factors for VTEs (P = .01; OR, 13.6). CONCLUSIONS: In this study, symptomatic VTEs were rare and occurred infrequently, with an incidence of 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. LEVEL OF EVIDENCE: Level III, case-control study.
PURPOSE: To (1) determine the incidence of symptomatic venous thromboembolic events (VTEs) after knee arthroscopy and arthroscopy-assisted procedures at a single institution and (2) determine associated risk factors for VTEs in these patients. METHODS: The records of patients who underwent knee arthroscopy at a single institution between 1988 and 2008 were reviewed. Chemoprophylaxis was not routinely used. Confirmed VTEs occurring within 4 weeks after the index arthroscopy procedure were included. A 2:1 matched control group was generated to include patients in whom knee arthroscopy was performed by the same surgeon either on the same day or immediately before each case resulting in a VTE. Preoperative and perioperative data were collected with respect to demographic data, medical history, medications, and surgical and anesthesia data. Univariate and multivariate analyses were performed. RESULTS: During the study period, 12,595 patients underwent knee arthroscopy. Among these patients, 43 cases of VTEs (35 deep venous thromboses [DVTs], 5 pulmonary embolisms [PEs], and 3 DVTs that progressed to PEs) occurred, resulting in an incidence of 0.30% (95% confidence interval [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. Factors associated with an elevated risk of symptomatic postoperative VTEs included a history of malignancy (P = .01; odds ratio [OR], 6.3), a history of VTEs (P = .02; OR, 5.2), or the presence of more than 2 classic risk factors for VTEs (P = .01; OR, 13.6). CONCLUSIONS: In this study, symptomatic VTEs were rare and occurred infrequently, with an incidence of 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. LEVEL OF EVIDENCE: Level III, case-control study.
Authors: Corey W Hunter; Timothy R Deer; Mark R Jones; George C Chang Chien; Ryan S D'Souza; Timothy Davis; Erica R Eldon; Michael F Esposito; Johnathan H Goree; Lissa Hewan-Lowe; Jillian A Maloney; Anthony J Mazzola; John S Michels; Annie Layno-Moses; Shachi Patel; Jeanmarie Tari; Jacqueline S Weisbein; Krista A Goulding; Anikar Chhabra; Jeffrey Hassebrock; Chris Wie; Douglas Beall; Dawood Sayed; Natalie Strand Journal: J Pain Res Date: 2022-09-08 Impact factor: 2.832
Authors: Romina Brignardello-Petersen; Gordon H Guyatt; Rachelle Buchbinder; Rudolf W Poolman; Stefan Schandelmaier; Yaping Chang; Behnam Sadeghirad; Nathan Evaniew; Per O Vandvik Journal: BMJ Open Date: 2017-05-11 Impact factor: 2.692
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: Austin V Stone; Avinesh Agarwalla; Anirudh K Gowd; Cale A Jacobs; Jeffrey A Macalena; Bryson P Lesniak; Nikhil N Verma; Anthony A Romeo; Brian Forsythe Journal: Orthop J Sports Med Date: 2019-01-28