Abstract
Background
This clinical study was performed to establish the prevalence of deep vein thrombosis and pulmonary embolism after shoulder surgery. The incidence of VTE complicating shoulder surgery is poorly described in literature.
Methods
We reviewed retrospectively clinical records of all patients who had any surgical procedure performed on their shoulder between 2001 and 2009.‘Patients’ records were assessed for any admissions due to proven VTE; we looked for any radiological results suggestive of venous thromboembolism.
Results
We identified 920 patients who had surgical procedure under GA on their shoulder; including 113 patients had shoulder arthroplasty. There was 1 fatal PE in this group – patient died within 48 hours following reverse shoulder replacement, post mortem revealed massive pulmonary embolism. There were 2 cases of symptomatic DVT of lower limb, both treated successfully with anticoagulation. No upper limb DVT was identified. There were 7 patients who had negative tests for suspected thrombosis.
Discussion
Recent studies suggest that DVT incidence following arthroplasty is as high as 13%. In our study we examined occurrence of symptomatic VTE only. According to our results the incidence of symptomatic DVT following shoulder surgery is about 0.3% and symptomatic PE about 0.1 %. The prevalence of asymptomatic VTE is probably much higher and further research needs to be undertaken in that area. We would advice to think carefully about risk of thrombosis and use mechanical prophylaxis in shoulder surgery. We would not recommend routine postoperative anticoagulation as a DVT prophylaxis unless there are additional risk factors.
