Purpose
To determine the incidence of and risk factors for symptomatic venous thromboembolism
(VTE) after hip arthroscopy (HA) and thromboprophylaxis prescription utilization for
this procedure.
Methods
The PearlDiver Mariner database was queried using Current Procedural Terminology codes
to identify adult patients (aged ≥ 18 years) who underwent HA between 2010 and 2020.
Patient demographic information, including age, oral contraceptive use, and medical
comorbidities, as well as perioperative thromboprophylaxis utilization, was recorded
using International Classification of Diseases codes and National Drug Codes. The incidence of postoperative VTE within 90 days
was determined. Multivariate logistic regression was used to identify predictors of
perioperative thromboprophylaxis utilization and risk factors for VTE.
Results
The queried records identified 60,181 patients who met the inclusion criteria. Of
these patients, 367 (0.6%) experienced VTE, including deep venous thrombosis (0.5%)
and/or pulmonary embolism (0.2%). Approximately 2.1% of patients used thromboprophylaxis,
including aspirin (1.1%), low-molecular-weight heparin (0.9%), and oral factor Xa
inhibitors (0.1%). Oral contraceptive pill use (adjusted odds ratio [aOR], 2.16; 95%
confidence interval [CI], 1.34-3.46), obesity (aOR, 1.37; 95% CI, 1.05-1.79), and
a history of malignancy (aOR, 1.69; 95% CI, 1.12-2.54) were associated with increased
odds of experiencing VTE. Perioperative thromboprophylaxis (aOR, 0.52; 95% CI, 0.19-1.39)
was not significantly associated with decreased odds of experiencing VTE. However,
obesity (aOR, 1.17; 95% CI, 1.00-1.38) and hypertension (aOR, 1.17; 95% CI, 1.02-1.36)
were associated with increased odds of thromboprophylaxis prescription utilization.
Conclusions
Although the overall risk of symptomatic VTE after HA remains low, oral contraceptive
use, obesity, and a history of malignancy are associated with increased odds of thromboembolic
events within 90 days. Routine thromboprophylaxis after HA may not be indicated in
all patients but can be considered based on patient-specific risk factors.
Level of Evidence
Level III, retrospective prognostic comparative trial.
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Article info
Publication history
Published online: November 01, 2022
Accepted:
October 20,
2022
Received:
May 8,
2022
Footnotes
See commentary on page 988
The authors report the following potential conflicts of interest or sources of funding: C.B.M. receives research support from Anika, Histogenics, Samumed, and Zimmer; is a paid consultant for ConMed Linvatec, Histogenics, Medacta, Stryker, and Tornier; and receives publishing royalties from SLACK, outside the submitted work. B.T.F. is Associate Editor of Journal of Shoulder & Elbow Surgery; is Editor in Chief of Current Reviews in Musculoskeletal Medicine; receives research support from National Institutes of Health, US Department of Veterans Affairs, Orthofix, and Stryker; and owns stock in Bioniks and Kaliber.ai. D.A.L. receives fellowship-related research grants from Arthrex and Smith & Nephew, outside the submitted work. A.L.Z. is a consultant for Stryker and DePuy Mitek, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
