The Incidence of Deep Venous Thrombosis After Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction

Sun, Yueqi; Chen, Dongyang; Shi, Dongquan; Dai, Jin; Qin, Jianghui; Jizhen, Qin; Ying, Pu; Hou, Huacheng; Sun, Weiyong; Jiang, Qing

doi:10.1016/j.arthro.2013.01.017

Cited by 40 publications

(61 citation statements)

References 22 publications

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“…It reports on only clinically symptomatic VTE in patients undergoing multiligamentous knee reconstruction and thus it is likely we underestimated the frequency of VTE relative to what might have been discovered had a screening procedure such as ultrasound been used. For example, Ye et al [55] found a rate of VTE in their patients undergoing arthroscopic ACL reconstruction of 14% diagnosed through screening venography; however, they did not comment on how many of these would have been diagnosed based on clinical symptoms only. As already mentioned, the low number of clinically symptomatic patients reported in our series made further statistical analysis impossible.…”

Section: Discussionmentioning

confidence: 99%

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Born¹,

Engasser

King

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Reconstruction of the multiligament-injured knee often involves extended surgical and tourniquet use times and often is performed in patients who have sustained concomitant fractures as well as vascular injuries, all of which would appear to predispose the patient to the potentially serious complications of deep vein thrombosis and perhaps pulmonary embolism, yet little is known about the frequency of venous thromboembolic (VTE) events after multiligamentous knee reconstruction. Questions/purposes The purposes of this study were to (1) determine the frequency of symptomatic VTE after multiligamentous knee reconstruction at a single institution; and (2) to determine associated risk factors for VTE in these patients. Methods The records of 134 (63% of the 213 consented individuals in our longitudinal database) patients who underwent primary (129 [96%]) or revision (five [4%]) multiligamentous knee reconstruction at a single institution between 1992 and 2013 were retrospectively reviewed. With two patients undergoing procedures bilaterally, this resulted in a total of 136 multiligamentous knee reconstructions. VTE for which clinical symptoms were evident and confirmed by imaging within 3 months after the reconstructive procedure was noted. Pre-and perioperative data were collected with respect to demographics, associated injuries, medical history, smoking status, and surgical data. Standard rehabilitation and thromboprophylaxis protocols were used in all patients. Results Three cases of symptomatic VTE (three deep vein thromboses) occurred after the 136 reconstructions (2%; 95% confidence interval, 0.53%-7.3%). Two of the three patients were obese and the remaining patient smoked and abused alcohol. However, as a result of a low frequency of VTE, no risk factors could be identified in this series. Conclusions Symptomatic VTE occurred in 2% of multiligamentous knee reconstructions at our institution while receiving thromboprophylaxis. This is similar to rates documented after anterior cruciate ligament reconstruction without thromboprophylaxis. Further multicenter research is required to identify the true frequency of and risk factors for developing VTE in patients undergoing multiligamentous knee reconstruction after knee dislocation. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Born¹,

Engasser

King

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…[17,28] In our study, none of the patients developed symptomatic PE during thrombolysis, and batroxobin's effect on thrombolysis was significant. Furthermore, no vena cava filter was applied during treatment.…”

Section: Discussionmentioning

confidence: 72%

“…[1,5,15,16] However, some reported incidences have been higher, at 7.2% to 41.2%, after arthroscopic ACL reconstruction, which is strongly suggestive of a need for routine thromboprophylaxis. [3,8,9,13,17] …”

Section: Discussionmentioning

confidence: 99%

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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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“…Venous ultrasound has shown the prevalence of asymptomatic lowerextremity DVT to be 1.5% to 14% among patients who have undergone arthroscopic ACL reconstruction without systemic anticoagulation [12][13][14] . However, the rate of symptomatic lowerextremity DVT following arthroscopic ACL procedures has been reported to be <0.3% 1,2 , with extension into the pelvic vasculature being a rare event 14 . Although a tourniquet was not used in the case of our patient, the use of a tourniquet has not been shown to be associated with an increased risk of DVT postoperatively 15,16 .…”

Section: Discussionmentioning

confidence: 99%

Extensive Lower-Extremity Deep Venous Thrombosis Following Arthroscopic Anterior Cruciate Ligament Reconstruction Related to May-Thurner Syndrome

Ackerman

Kurdziel

Dutcheshen

2015

JBJS Case Connector

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The Incidence of Deep Venous Thrombosis After Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction

Cited by 40 publications

References 22 publications

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

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

Extensive Lower-Extremity Deep Venous Thrombosis Following Arthroscopic Anterior Cruciate Ligament Reconstruction Related to May-Thurner Syndrome

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