Incidence of venous thromboembolism after elective knee arthroscopic surgery: a historical cohort study

K F Mauck, D A Froehling, P R Daniels, D L Dahm, A A Ashrani, D J Crusan, T M Petterson, K R Bailey, J A Heit
Journal of Thrombosis and Haemostasis: JTH 2013, 11 (7): 1279-86

BACKGROUND: The incidence of symptomatic venous thromboembolism (VTE) after knee arthroscopy is uncertain.

OBJECTIVES: To estimate the incidence of symptomatic VTE after arthroscopic knee surgery.

METHODS: In a population-based historical cohort study, all Olmsted County, MN, USA, residents undergoing a first arthroscopic knee surgery during the 18-year period of 1988-2005 were followed for incident deep venous thrombosis or pulmonary embolism. The cumulative incidence of VTE after knee arthroscopy was determined using the Kaplan-Meier product limit estimator. Patient age at surgery, sex, calendar year of surgery, body mass index, anesthesia characteristics, and hospitalization were tested as potential predictors of VTE using Cox proportional hazards modeling, both univariately and adjusted for age and sex.

RESULTS: Among 4833 Olmsted County residents with knee arthroscopy, 18 developed postoperative VTE, all within the first 6 weeks after surgery. The cumulative incidence rates of symptomatic VTE at 7, 14, and 35 days were 0.2%, 0.3%, and 0.4%, respectively. The hazard for postoperative VTE was significantly increased for older patient age (hazard ratio = 1.34 for each 10-year increase in patient age; P = 0.03) and hospitalization either before or after knee arthroscopy (hazard ratio = 14.1; P < 0.001).

CONCLUSIONS: The incidence of symptomatic VTE after arthroscopic knee surgery is very low. Older age and hospitalization are associated with increased risk. Routine prophylaxis to prevent symptomatic VTE is likely not needed in this patient population.

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