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Risk of deep vein thrombosis in patients undergoing knee arthroscopy

Moreno, Hugo Armando Rodrígueza; Hortua, Pedrob; Rocha, Cesarc; Diaz Granados, Carlos A.d; Espinel, Camiloc; Cortes, Luis Emilioc; Jimenez, Diegoc

doi: 10.1097/BCO.0b013e3181a5ef0a

Background In this report we attempt to estimate the incidence of deep vein thrombosis in patients undergoing low-complexity knee arthroscopy and explore possible indications for anti-embolic prophylaxis according to the calculated probability of deep vein thrombosis.

Methods This is a prospective cohort study. Subjects were adult patients undergoing low-complexity knee arthroscopy between September 2001 and November 2004. Patients with a diagnosis of deep vein thrombosis before the procedure and those who were receiving anticoagulant medications were excluded. Doppler ultrasound was performed 8 and 30 days after the procedure. Multivariate logistic regression model was used to calculate the probabilities of deep vein thrombosis depending on the presence or absence of risk factors. One hundred and four patients were included.

Results The estimated incidence of deep vein thrombosis was 8.6% [95% confidence interval (CI) 3% to 14%]. Bivariate analysis showed an association between tourniquet duration time longer than 40 minutes and deep vein thrombosis (P=0.019). Multivariate logistic regression analysis confirmed that association (OR=14.7, 95% CI 1.4-157, P=0.02) and showed a trend towards significance for the association between hormonal therapy and deep vein thrombosis (OR=10.9, 95% CI 0.6-187, P=0.09). According to the logistic regression model, seven different clinical scenarios showed a high probability of deep vein thrombosis.

Conclusions The risk of deep vein thrombosis in patients undergoing low-complexity knee arthroscopy may be high enough to justify antiembolic prophylaxis depending on the absence or presence of risk factors. Prolonged tourniquet duration time is associated with deep vein thrombosis.

Level of Evidence Level II (prognostic study with patient enrollment at the same time in their disease process and completed follow-up for more than 80% of the patients).

aAdult Hip and Knee Reconstruction–Clinica Infantil Colsubsidio-Hospital De San Jose

bOrthopaedic Surgeon-Clinica Colombia-Bogota

cFundacion Cardio Infantil-Bogota

dDivision de Investigaciones Hospital, De San Jose–Bogota, Colombia

Correspondence to Hugo Armando Rodríguez Moreno, MD, Adult Hip and Knee Reconstruction, Clinica Infantil Colsubsidio, CLL 67 NO 10-67 Cons 311, Bogota, Colombia

Tel: +011 571 2544200; fax: +011 571 6854567;


© 2009 Lippincott Williams & Wilkins, Inc.