Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleDeep Venous Thrombosis After Knee Arthroscopy: A Meta-analysis
Section snippets
Methods
A MEDLINE search was performed to find published English-language studies of DVT following knee arthroscopy from 1966 to December 2004. Combinations of the medical subject headings—DVT, thromboembolism, knee, arthroscopy, incidence, surgery, and venous thrombosis—were used to identify all articles that evaluated the incidence of DVT after knee arthroscopy. Bibliographies of retrieved articles were checked for any additional studies. Strict inclusion criteria required any investigation included
Results
The unprophylaxed patient populations in the 6 studies that met inclusion criteria ranged from 64 to 184, and totaled 684 patients. Two studies screened with ascending contrast venography, and 4 studies used ultrasonography. For 3 investigations, including the 2 that used venography, the entire population underwent knee arthroscopy without prophylaxis.6, 9, 10 Two of the remaining 3 studies included a discrete patient group given low-molecular-weight heparin as prophylaxis11, 12 and the third
Discussion
Before valid recommendations can be made regarding DVT prophylaxis after knee arthroscopy, it is imperative to establish a reliable estimate of the incidence of this complication. Several prospective studies have attempted this, but each contains a small number of subjects relative to similar studies looking at thromboembolic events following total hip or total knee arthroplasty. Given the current lack of large studies, a meta-analysis combining several studies using strict inclusion criteria
Conclusions
DVT following knee arthroscopy is a consistent finding in studies of unprophylaxed patients when routine screening using ultrasound or contrast venography is used. This meta-analysis of the current literature suggests an overall DVT rate of 9.9% and a proximal DVT rate of 2.1% following knee arthroscopy without antithrombosis prophylaxis.
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