Thromboembolism Following Shoulder Arthroscopy

Abstract

Background:Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks.Purpose:To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication.Study Design:Case-control study; Level of evidence, 3.Methods:A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy.Results:A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery.Conclusion:The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All cases were positioned in the beach-chair position. Further analysis of future cases is warranted.

Oral Contraceptive Pills Are Not a Risk Factor for Deep Vein Thrombosis or Pulmonary Embolism After Arthroscopic Shoulder Surgery

“…The risk of VTE after shoulder surgery is low, with rates quoted between 0% and 5.7% 6,15,25 ; for arthroscopic shoulder surgery, the rates of symptomatic VTE are extremely low, ranging from 0.01% to 0.38%. 3,6,11,15,20,25 In this investigation, the rate of VTE after arthroscopic shoulder surgery (0.57%) was higher than what has been previously reported. OCP use is widespread and relevant to the patient population that may undergo arthroscopic shoulder surgery.…”

Pulmonary Embolism after Arthroscopic Bankart and Rotator Cuff Repair

“… 1 , 12 The exact incidence is unknown and only found in either case reports or small case series. 1 – 3 , 7 8 10 , 11 – 21 , 23 , 24 Burkhart et al 26 was the first to report a case of a 32-year-old man who developed DVT in 1990 following shoulder arthroscopy, and Kim et al 15 was the first to report a case of a 45-year-old woman who developed a fatal PE in the contralateral axillary vein thrombosis after elective arthroscopic rotator cuff repair in 2010. Goldhober et al 8 presented a unique case of a 43-year-old female who developed a PE 41 days after repair of the rotator cuff, a distal clavicle excision, and a miniopen subpectoralis long head biceps tenodesis.…”

“…Schick et al 10 performed a retrospective case control review with 15,033 shoulder arthroscopy cases from 17 surgeons. The two study groups were the VTE group and the control group.…”

Review: Complications of Rotator Cuff Surgery

“…Yapılan bir çalışmada, omuz cerrahisi sonrası alt ekstremitede %0,15 oranda DVT bildirilmiş olup, tüm olgular şezlong pozisyonunda opere edilmişlerdir (20) . Benzer bir çalışmada, 175 hasta içinde %5,7 oranda alt ekstremite DVT'si ve bir hastada pulmoner emboli görülmüştür (21) .…”