The incidence of venous thromboembolism (VTE)--after hip arthroscopy

• Published in: Bulletin of the Hospital for Joint Diseases (2013) 2014-06, Vol.72 (2), p.154-158
• Main Authors: Alaia, Michael J, Patel, Deepan, Levy, Anna, Youm, Thomas, Bharam, Srino, Meislin, Robert, Bosco Iii, Joseph, Davidovitch, Roy I
• Format: Article
• Language: English
• Subjects: Adult; Arthroscopy - adverse effects; Arthroscopy - instrumentation; Arthroscopy - methods; Biomechanical Phenomena; Body Mass Index; Contraceptives, Oral, Hormonal - adverse effects; Equipment Design; Female; Hip Joint - physiopathology; Hip Joint - surgery; Humans; Incidence; Male; Middle Aged; New York City - epidemiology; Overweight - diagnosis; Overweight - epidemiology; Predictive Value of Tests; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - epidemiology; Recovery of Function; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Traction; Treatment Outcome; Ultrasonography, Doppler, Duplex; Venous Thromboembolism - diagnostic imaging; Venous Thromboembolism - epidemiology; Venous Thrombosis - diagnostic imaging; Venous Thrombosis - epidemiology; Weight-Bearing
• ISSN: 2328-5273

The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after hip arthroscopy. Over the course of 13 months, four surgeons that routinely perform hip arthroscopy participated in a protocol to screen all patients postoperatively for deep venous thrombosis (DVT) using bilateral venous duplex ultrasound at or about the 2 week postoperative time point. All patients were assessed and stratified for VTE risk prior to surgery. Mechanical intraoperative and postoperative chemoprophylaxis were not administered. Perioperative factors, such as weightbearing status after surgery, traction time, and anesthesia type, were recorded. We identified 139 eligible patients (average age 37.7, SD = 12.0) that underwent hip arthroscopy. The incidence of symptomatic VTE was 1.4 percent (2/139). Of the entire patient pool, 81 obtained a follow-up ultrasound. There were no cases of asymptomatic deep vein thrombosis (DVT). There were two symptomatic venous thromboembolic events noted; one DVT and one pulmonary embolus. One patient had no risk factors; the other was overweight and routinely took oral contraceptives. Amongst the patient cohort, the mean BMI was 25.9 (SD = 4.8). The mean traction time was 58.9 minutes (SD = 23.1). Most patients (71%) were partial weightbearing after the procedure. In patients undergoing hip arthroscopy, the rate of postoperative VTE was low, despite the use of prolonged axial traction and surgical proximity to the pelvic veins. Although patients should be counseled preoperatively regarding the risk of VTE, we believe that routine use of pharmacologic prophylaxis is not indicated following hip arthroscopy if patients are properly risk stratified prior to surgery and found to be at low risk for VTE.