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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_20 | Pages 25 - 25
1 Apr 2013
Raghavendra M Sinha A Widdowson D
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Deep vein thrombosis (DVT) in shoulder operations is rare although a few case reports exist. No definite guidelines exist and therefore it is difficult for the surgeon to decide on thromboprophylaxis.

We prospectively evaluated the incidence of DVT following arthroscopic shoulder sub acromial decompression in 72 patients after obtaining local ethics committee approval. Patients with previous history of DVT and those on anticoagulants were excluded from the study. Pre and post-operative Doppler scans on 4 limbs were performed by a single consultant radiologist at an average of 3 weeks. All operations were performed by a single surgeon under GA in beach chair position as a day case procedure on standard lines. Postoperatively the shoulder was immobilised in a sling for comfort and physiotherapy was supervised by a qualified therapist. No patient received any DVT prophylaxis.

The average age of 54.6 years, 47 were classified as ASA 1, 15 as ASA 2 and 10 ASA 3.58 patients had additional interscalene nerve blocks for pain relief. The average operating time was 43 mins. Additional procedures included excision of lateral clavicle in 32, glenoid labral and rotator cuff debridement in 12 and 14 patients. There were no DVTs on Doppler scans. Shoulder arthroscopic sub acromial decompression procedures do not carry a risk of DVT and routine thromboprohylaxis is not required even in higher anaesthetic risk patients.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 44 - 44
1 Jan 2013
Raghavendra M Sinha A Widdowson D
Full Access

We obtained approval from the local research and ethics committee and prospectively evaluated the incidence of Deep vein thrombosis (DVT) in arthroscopic shoulder sub acromial decompression in 72 patients. All patients were assessed clinically for DVT risks as per the established guidelines. Patients with previous history of DVT, those on anticoagulants and those positive for DVT on pre op scans were excluded from the study. All patients had doppler scans on 4 limbs performed by a single consultant radiologist at an average of 4 weeks pre and post operative period. All operations were performed by a single surgeon under GA in beach chair position with routine precautions for DVT, as a day case procedure. Arthroscopy and additional procedures were performed on standard lines. Postoperatively the shoulder was immobilised in a sling for comfort and physiotherapy was supervised by a qualified therapist. Demographic data, co-morbidities, patient position, ASA risk, nerve blocks, surgery duration, medications, intra operative findings, were documented. No patient received any DVT prophylaxis. All patients were available for followup and clinical and doppler findings were documented at an average 4 week period. 3 patients had bilateral procedures. There were 38 female and 34 male patients with an average age of 54.6 years. 47 were classified as ASA1, 15 as ASA2 and 10 ASA 3. Common co morbidities included hypertension, diabetes, acid peptic disease in 34 patients. 37 patients had additional interscalene nerve blocks for pain relief. The average operating time was 52 mins. Additional procedures included excision of lateral clavicle in 32, glenoid labral and rotator cuff debridement in 12 and 14 patients. There were no DVT's on all doppler scans. Shoulder arthroscopic sub acromial decompression procedures do not carry a risk of DVT and routine thromboprohylaxis is not required even in higher anaesthetic risk patients.