THROMBOEMBOLIC COMPLICATIONS AFTER ARTHROSCOPIC KNEE SURGERY - INCIDENCE AND RISK-FACTORS IN 101 PATIENTS

Deep venous thrombosis (DVT) and pulmonary embolism (PE) are less comm on after knee arthroscopy than after elective hip and knee arthroplast ies. There is no consensus on the optimal prophylaxis. In this prospec tive cohort study, we used ultrasound, phlebography and lung scan pre- and postoperatively to assess the incidence of thromboembolic complic ations in 101 consecutive patients who underwent knee arthroscopy. Pre operatively, patients were screened for typical risk factors for DVT s uch as age, obesity, varicose veins, contraceptive pills and nicotine abuse. All patients received a once-daily injection of 5000 IU of low molecular weight heparin, at least 12 hours prior to surgery. 5 weeks after surgery, the same screening tests were repeated. In 12 of the 10 1 patients either DVT or PE was diagnosed. DVT occurred in 8 cases, 4 of which were silent and 4 symptomatic. The number of PEs was 9, 8 sil ent and 1 symptomatic. We found no correlation between DVT or PE and i ndividual clinical risk factors, but there was a tendency towards the development of DVT and PE, with a higher number of risk factors. We fo und no correlation between DVT and intraoperative risk factors such as use of a tourniquet, type of anesthesia or duration of surgery. The r elatively high rate of thromboembolic events after knee arthroscopy in our study suggests the need of all patients for routine use of thromb oprophylaxis, probably in a higher dose than given.