Purpose
To establish a contemporary literature-based estimate of the incidence of deep venous
thrombosis (DVT) after knee arthroscopic surgery.
Methods
We performed a systematic review and meta-analysis of the English language literature
to assess the efficacy of prophylaxis to prevent DVT after knee arthroscopic surgery.
Only randomized controlled trials (RCTs) or prospective studies were considered. Studies
were excluded if they were not original prospective studies concerning DVT detected
by imaging after knee arthroscopic surgery. We calculated pooled proportions of postoperative
DVT and proximal DVT.
Results
Nine prospective uncontrolled studies and 4 RCTs were retrieved. Within them, the
populations given low-molecular-weight heparin (LMWH) to prevent DVT had a 0.1% to
11.9% incidence of DVT, with an overall 36 DVTs identified (4 proximal), averaging
1.8%. One hundred thirty-six DVTs (29 proximal) were indicated in the populations
without prophylaxis, and the DVT incidence varied from 1.8% to 41.2%, averaging 6.8%.
Of the RCTs, the pooled risk ratio for DVT to develop was 0.180 (range, 0.065 to 0.499)
for those who had LMWH as prophylaxis. An absolute risk reduction of 1.2%—from 1.5%
to 0.3%—for the development of proximal DVT was observed.
Conclusions
Compared with patients who did not receive prophylaxis, the pooled risk ratio for
the development of DVT was 0.18 for those who had LMWH prophylaxis. The incidence
of proximal DVT is very low after arthroscopic surgery regardless of receiving prophylaxis
(4 of 2,184) or not (29 of 1,814). The rate of proximal DVT in total DVT occurrence
can be markedly reduced from 21.3% (29 of 136) to 11.1% (4 of 36).
Level of Evidence
Level IV. This study is a meta-analysis of RCTs and a systematic review of Level IV
studies.
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Article info
Publication history
Accepted:
December 31,
2013
Received:
May 8,
2013
Footnotes
Supported by grants from the National Natural Sciences of China (No. 30973046) and China National Funds for Distinguished Young Scientists (No. 81125013).
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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