Abstract
Knee arthroscopy is the most commonly performed orthopaedic operation world wide. There is however little data on the incidence of DVT and consequently there is no consensus regarding the need for periopeartive thromboprophylaxia. Hoppener et al,2003 reported a high incidence of 11% DVT without the use of thromboprophylaxis.
The aim of our study was to establish the incidence of venous thromboembolic complications in day case knee arthroscopy without any thromboprophylaxis
A retrospective review of 458 consecutive knee arthroscopies done in our unit between Feb 1998 to May 2007 were carried out. They were all day cases and did not receive any chemical thromboprophylaxis. All the case notes were carefully scrutinized for any readmissions for symptoms of venous thromboembolism(VTE). The clinical signs documented were pain, tenderness, swelling or redness of the legs, dyspnoea, chest pain and haemoptysis leg pains or redness following the surgery.
There were 278 males and 180 females. The age group ranged from 15 to 88 years. The average age group was 57.7years. The primary out come of the study was the incidence of symptomatic and asymptomatic venous thromboembolic complications after the knee arthroscopy during the 2 week and 8 week followup period. Our study showed there were no cases of symptomatic deep vein thrombosis in any of the patients.
The pooled overall estimate of the incidence of all VTE, without the use of thromboprophylaxis was 7.4%, symptomatic 2% and asymptomatic 5.4%. This is not in agreement with our study. The limitation of our study, it is a retrospective analysis and no investigative tools were used.
We conclude that until more extensive studies have been performed, it seems justified to withhold thromboprophylaxis in patients undergoing uncomplicated knee arthroscopic procedures in a daycare setting..
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
