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A Successful Collaborative Approach to the Perioperative Management After Hip Arthroscopy of a Patient with Heterozygous Prothrombin G20210A Mutation

A Case Report

Parsa, Ali MD1,2; Nazal, Mark R. MPH1; Stelzer, John W. MS1; Sieff, Colin A. MBBCh3; Martin, Scott D. MD1

doi: 10.2106/JBJS.CC.18.00376
Case Reports
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Disclosures

Case: We report on a patient with heterozygous prothrombin G20210A mutation (PTM) and a history of venous thromboembolism (VTE) after knee arthroscopy, who was undergoing hip arthroscopy. This common mutation has an overall prevalence of 2.0% and results in a 280% to 420% likelihood of thrombosis compared to patients without the mutation.

Conclusions: Hip arthroscopy is associated with a low risk of VTE with currently no guidelines for thromboprophylaxis. Patients should be managed in relation to their risk factors utilizing a collaborative, individualized approach. Treatment with short-term low-molecular-weight heparin resulted in no thromboembolism at 18-month follow-up for this patient with PTM.

1Department of Orthopaedic Surgery, Sports Medicine, Massachusetts General Hospital, Partners Heath System, Boston, Massachusetts

2Orthopedic Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran

3Division of Hematology/Oncology, Dana-Farber and Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts

E-mail address for M.R. Nazal: mnazal@mgh.harvard.edu

Investigation performed at the Massachusetts General Hospital, Partners Health System, Boston, Massachusetts

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/A794).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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