Purpose
To establish the incidence of venous thromboembolic complications as detected by bilateral
complete compression ultrasonography (CCUS) after arthroscopic anterior cruciate ligament
(ACL) reconstruction without thromboprophylaxis.
Methods
We performed a prospective cohort study to establish the incidence of venous thromboembolic
complications after arthroscopic ACL reconstruction, as detected by bilateral CCUS
at 14 days (range, 11 to 17 days) postoperatively. One hundred consecutive patients
underwent bilateral extended ultrasonography.
Results
One hundred predominantly European patients with a mean age of 30 ± 10 years and mean
body mass index of 25 ± 4 underwent ACL reconstruction with a mean operative duration
of 68 ± 23 minutes and a tourniquet time of 76 ± 23 minutes. In 84% of patients an
autologous hamstring graft was used, in 14% a bone–patellar tendon–bone graft was
used, and 2 patients received an allograft. Of 100 patients, 9 (incidence, 9%; 95%
confidence interval, 4.2 to 16.4) showed asymptomatic proximal or distal deep vein
thrombosis on CCUS, of whom 4 (incidence, 4%; 95% confidence interval, 1.1 to 9.9)
were symptomatic. A nonfatal pulmonary embolus developed in 1 patient during the 8-week
follow-up period.
Conclusions
This study shows that the incidence of venous thromboembolism after arthroscopic ACL
reconstruction is relatively high; a 9% incidence of asymptomatic proximal or distal
deep vein thrombosis was found, whereas 4% of patients were symptomatic. Further research
is recommended to assess the need for thromboprophylaxis in patients undergoing ACL
reconstruction, especially when risk factors are present.
Level of Evidence
Level IV, case series.
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Article Info
Publication History
Accepted:
April 16,
2013
Received:
October 17,
2012
Footnotes
The ultrasonography scans were funded by the orthopaedic research fund of the Isala Clinics, which received a research grant provided by GlaxoSmithKline. The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
