Patients undergoing ACL reconstruction at risk for DVT, but may be asymptomatic
Study identified 47% DVT risk after arthroscopic ACL reconstruction in patients over 30 years old.
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FLORENCE Japanese surgeons have identified a 21% rate of deep venous thrombosis after arthroscopic ACL reconstruction, a rate higher than those found in earlier investigations, according to a study presented here.
The increased rate of deep venous thrombosis (DVT) found in this new study could be due to two factors: (1) The patients did not receive pharmacological DVT prophylaxis. (2) The surgeons used special DVT screening methods, which may have helped to better detect thromboembolic events, said Masayuki Inoue, MD, PhD, of Sapporo, Japan.
He presented the study findings at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress.
Inoue and colleagues studied 52 patients who underwent arthroscopic ACL reconstruction involving an anatomic double-bundle hamstring tendon technique. The study included 33 men and 19 women ranging in age from 15 to 51 years. No patients had a history of either DVT or previous surgery in the same leg.
Surgeons used an air tourniquet, however no patients received pre- or postoperative DVT pharmacoprophylaxis. Postoperative DVT management consisted of foot pumps.
After 1 week, investigators used a specialized Doppler ultrasound technique on all the patients. They found no pulmonary emboli, one proximal DVT in a vein peripheral to the popliteal vein (2%), and 10 patients with a distal DVT (19%).
Most of the 11 DVTs occurred in the patient's leg on the operated side, and 91% of DVT cases overall were asymptomatic, Inoue said.
Investigators compared DVT risk factors among patients with and without DVT, including age, D-dimer results, gender, obesity, surgical time and tourniquet time. Of patients with a DVT, 47% were 30 years of age or older, which was significantly higher than the younger group (P=.002).
Other risk factors, such as surgical and tourniquet times, were not significantly different between the groups, according to Inoue.
For more information:
- Masayuki Inoue, MD, has no financial disclosures related to this study.
- Inoue M, Taki K, Kaneko S, et al. Risk factor of deep venous thrombosis after arthroscopic ACL reconstruction. # 191. Presented at the 2007 International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress. May 27-31, 2007. Florence.