Does Anterior Cruciate Ligament Reconstruction Increase Venous Thromboembolism Risk Compared with Knee Meniscectomy Under Arthroscopy?

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2022 Mar 19

PMID 35303852

Authors

Long Pang

Pengcheng Li

Hui Li

Xin Tang

Jing Zhu

Affiliations

Soon will be listed here.

Abstract

Background: This study compared the incidence of postoperative venous thromboembolism (VTE) between meniscectomy and anterior cruciate ligament reconstruction (ACLR) under arthroscopy and assessed whether ACLR increases the VTE risk compared with meniscectomy.

Methods: A retrospective study of prospectively collected clinical data, including data on 436 patients ranging in age from 18 to 60 years who underwent ACLR or meniscectomy surgery, was performed between October 2018 and October 2019 in our hospital. All patients underwent routine VTE screening by venous ultrasonography in postoperative week 2 and then clinical follow-up at 4 and 6 weeks post-surgery. The incidence of VTE was calculated, and clinical factors such as age, sex, body mass index (BMI), smoking, concomitant procedure, Caprini score, and duration of tourniquet use were evaluated in relation to the risk factors for VTE.

Results: A total of 320 patients who underwent arthroscopic ACLR or meniscectomy were available for analysis. Of these patients, 130 (40.6%) underwent ACLR, and 190 (59.4%) underwent meniscectomy. No cases of pulmonary embolism (PE) or femoral deep vein thrombosis (DVT) were reported in either group. Fourteen patients (10.8%) developed VTE in the ACLR group compared with 10 (5.3%) in the meniscectomy group, with no significant difference (p = 0.066). Among these patients, 4 (3.1%) patients in the ACL reconstruction group and 2 (1.1%) patients in the meniscectomy group had DVT confirmed by Doppler ultrasound (p > 0.05). ACLR, age, and BMI (OR = 3.129; 1.061; 1.435) tended to increase the risk of VTE, but the results were not statistically significant (p = 0.056, 0.059, 0.054).

Conclusions: The incidence of VTE after ACLR and meniscectomy within 6 weeks post-surgery was 10.8 and 5.3%, respectively. ACLR, age, and BMI had a tendency to increase the risk of VTE.

Citing Articles

Risk factors for venous thromboembolism following knee arthroscopy: A systematic review and meta-analysis of observational studies.

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Association of Symptomatic Venous Thromboembolism and BMI in Patients Undergoing Sports Medicine Knee Procedures: A Retrospective Case-Control Study.

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References

Murphy R, Heyworth B, Kramer D, Naqvi M, Miller P, Yen Y . Symptomatic Venous Thromboembolism After Adolescent Knee Arthroscopy. J Pediatr Orthop. 2019; 39(3):125-129. DOI: 10.1097/BPO.0000000000000894. View

Traven S, Farley K, Gottschalk M, Goodloe J, Woolf S, Xerogeanes J . Combined Oral Contraceptive Use Increases the Risk of Venous Thromboembolism After Knee Arthroscopy and Anterior Cruciate Ligament Reconstruction: An Analysis of 64,165 Patients in the Truven Database. Arthroscopy. 2021; 37(3):924-931. DOI: 10.1016/j.arthro.2020.10.025. View

Oshiba H, Nawata M, Morioka S, Momose T, Maeda T, Nakatsuchi Y . The incidence and risk factor of deep venous thrombosis after arthroscopically assisted anterior cruciate ligament reconstruction. J Orthop Sci. 2019; 25(3):477-480. DOI: 10.1016/j.jos.2019.05.014. View

Nicolay R, Selley R, Terry M, Tjong V . Body Mass Index as a Risk Factor for 30-Day Postoperative Complications in Knee, Hip, and Shoulder Arthroscopy. Arthroscopy. 2019; 35(3):874-882.e3. DOI: 10.1016/j.arthro.2018.10.108. View

Gabriel R, Burton B, Ingrande J, Joshi G, Waterman R, Spurr K . The association of body mass index with same-day hospital admission, postoperative complications, and 30-day readmission following day-case eligible joint arthroscopy: A national registry analysis. J Clin Anesth. 2019; 59:26-31. DOI: 10.1016/j.jclinane.2019.06.012. View

van Adrichem R, Nelissen R, Schipper I, Rosendaal F, Cannegieter S . Risk of venous thrombosis after arthroscopy of the knee: results from a large population-based case-control study. J Thromb Haemost. 2015; 13(8):1441-8. DOI: 10.1111/jth.12996. View

Moll S . After the Fall - Prophylaxis for All?. N Engl J Med. 2017; 376(6):576-577. DOI: 10.1056/NEJMe1615445. View

Sing D, Luan T, Feeley B, Zhang A . Is Obesity a Risk Factor for Adverse Events After Knee Arthroscopy?. Arthroscopy. 2016; 32(7):1346-1353.e1. DOI: 10.1016/j.arthro.2016.01.017. View

Salzler M, Lin A, Miller C, Herold S, Irrgang J, Harner C . Complications after arthroscopic knee surgery. Am J Sports Med. 2013; 42(2):292-6. DOI: 10.1177/0363546513510677. View

10.

Graham W, Flanigan D . Venous thromboembolism following arthroscopic knee surgery: a current concepts review of incidence, prophylaxis, and preoperative risk assessment. Sports Med. 2013; 44(3):331-43. DOI: 10.1007/s40279-013-0121-2. View

11.

Caprini J . Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005; 51(2-3):70-8. DOI: 10.1016/j.disamonth.2005.02.003. View

12.

Ilahi O, Reddy J, Ahmad I . Deep venous thrombosis after knee arthroscopy: a meta-analysis. Arthroscopy. 2005; 21(6):727-30. DOI: 10.1016/j.arthro.2005.03.007. View

13.

Krych A, Sousa P, Morgan J, Levy B, Stuart M, Dahm D . Incidence and Risk Factor Analysis of Symptomatic Venous Thromboembolism After Knee Arthroscopy. Arthroscopy. 2015; 31(11):2112-8. DOI: 10.1016/j.arthro.2015.04.091. View

14.

Rubenstein W, Lansdown D, Feeley B, Ma C, Zhang A . The Impact of Body Mass Index on Complications After Shoulder Arthroscopy: Should Surgery Eligibility Be Determined by Body Mass Index Cutoffs?. Arthroscopy. 2019; 35(3):741-746. DOI: 10.1016/j.arthro.2018.10.136. View

15.

Jameson S, Dowen D, James P, Serrano-Pedraza I, Reed M, Deehan D . Complications following anterior cruciate ligament reconstruction in the English NHS. Knee. 2011; 19(1):14-9. DOI: 10.1016/j.knee.2010.11.011. View

16.

Falck-Ytter Y, Francis C, Johanson N, Curley C, Dahl O, Schulman S . Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl):e278S-e325S. PMC: 3278063. DOI: 10.1378/chest.11-2404. View

17.

Parker B, Hurwitz S, Spang J, Creighton R, Kamath G . Surgical Trends in the Treatment of Meniscal Tears: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database. Am J Sports Med. 2016; 44(7):1717-23. DOI: 10.1177/0363546516638082. View

18.

Bhatia S, LaPrade C, Ellman M, LaPrade R . Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 2014; 42(12):3016-30. DOI: 10.1177/0363546514524162. View

19.

Gaskill T, Pullen M, Bryant B, Sicignano N, Evans A, DeMaio M . The Prevalence of Symptomatic Deep Venous Thrombosis and Pulmonary Embolism After Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2015; 43(11):2714-9. DOI: 10.1177/0363546515601970. View

20.

Martin C, Pugely A, Gao Y, Wolf B . Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database. J Bone Joint Surg Am. 2013; 95(14):e98 1-10. DOI: 10.2106/JBJS.L.01440. View