To the Editor:
I read with interest the meta-analysis by Sun et al.,
1
and I would like to compliment the authors for a thorough review. It shows that thromboprophylaxis is important even for ambulatory care surgeries such as knee arthroscopy, and one should be vigilant in suspecting DVT.From the article,
1
it is not clear whether there are differences in the incidence of DVT when the aforementioned operation is performed in an ambulatory versus inpatient setting. I would appreciate the authors' thoughts on this.In addition, Sun et al.
1
mentioned that one of the limitations of the study was the exclusion of studies in which DVT was not screened for by radiographic means, which could lead to under-reporting. My group published a Level II study in which clinical screening was performed but no Doppler studies were performed, and the incidence was 0%.2
One has to bear in mind the financial implications of the investigations when clinical suspicion is low. I would appreciate the authors' thoughts on this, as well.References
- Deep venous thrombosis after knee arthroscopy: A systematic review and meta-analysis.Arthroscopy. 2014; 30: 406-412
- A comparison of early and delayed arthroscopically-assisted reconstruction of the anterior cruciate ligament using hamstring autograft.J Bone Joint Surg Br. 2010; 92: 521-526
Article info
Footnotes
The author report that he has no conflicts of interest in the authorship and publication of this letter.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Deep Venous Thrombosis After Knee Arthroscopy: A Systematic Review and Meta-AnalysisArthroscopyVol. 30Issue 3
- Authors' ReplyArthroscopyVol. 30Issue 7
- PreviewWe appreciate the opportunity to address the concerns raised by Dr. Anand about our recent publication. Regarding the ambulatory versus inpatient setting of the studies included in our meta-analysis, there were not enough included to make a proper comparison. Outpatients with arthroscopic surgery, as compared with inpatients, tend to undergo simpler surgical procedures that allow discharge on the surgical day. The procedure bias itself could affect the aforementioned comparison. With studies constantly emerging, this issue will be better addressed within studies with the same arthroscopic procedure.
- Full-Text
- Preview
