The Prevalence of Symptomatic Deep Venous Thrombosis and Pulmonary Embolism After Anterior Cruciate Ligament Reconstruction

Abstract

The incidence of VTE after ACL reconstruction in this large population was low. Increased odds of VTE was identified in patients aged ≥35 years with a history of nicotine use, anticoagulant use, concomitant HTO, or concomitant PCL reconstruction. Controlled studies are necessary to determine the efficacy of chemoprophylaxis and to develop evidence-based clinical practice guidelines to minimize VTE after ACL reconstruction.

Unexpectedly high incidence of venous thromboembolism after arthroscopic anterior cruciate ligament reconstruction: prospective, observational study

“…Although advanced age was shown to be the risk factor for DVT after ACLR, other factors, such as preoperative knee pain, revision ACLR and meniscus repair, were not significantly associated with DVT development. Based on a large database analysis, the incidence of DVT after ACLR was reported to be very low, ranging from 0.30% to 0.34% 1–3. In contrast, in a study that used venography to examine for DVT, the incidence was reported to be 14.0%,4 and with US, the incidence was reported to be 9% and 12.1%,5 6 almost the same as the present results.…”

“…Since the reported incidence of DVT following ACLR varies from 0.3% to 41.2%1–8 depending on different modalities used in the study and whether asymptomatic or symptomatic DVT was assessed, the true incidence of DVT after ACLR has not been well clarified. The incidence of symptomatic PE was reported to be 0.05%–0.21% from a large database analysis,1–3 but there have only been a few investigations of asymptomatic PE. Therefore, although pharmacological prophylaxis is reported to be effective for reducing DVT after ACLR,9 whether pharmacological prophylaxis is routinely needed after ACLR remains controversial.…”

Perioperative pain control is important for prevention of venous thromboembolism after around the knee osteotomy

“…Several studies have also mentioned VTEs after anterior cruciate ligament reconstruction (ACLR) [1].…”

“…In the relevant literature, the reported incidence of VTEs after TKA and ACL reconstruction was 0.36-62.5% [2][3][4], and 0.5% [1,6], respectively. The risk factors associated with VTEs after TKA included advanced age (> 70 years), drain use, and delayed ambulation (≥ 72 h) after surgery [4].…”

“…The risk factors associated with VTEs after TKA included advanced age (> 70 years), drain use, and delayed ambulation (≥ 72 h) after surgery [4]. The risk factors for VTEs after ACLR included age > 35 years, history of nicotine use, anticoagulant use, concomitant HTO, or concomitant posterior cruciate ligament (PCL) reconstruction [1]. However, there are few reports about VTEs after around the knee osteotomy (AKO).…”