Deep vein thrombosis after reconstructive shoulder arthroplasty: A prospective observational study

• Published in: Journal of shoulder and elbow surgery 2009, Vol.18 (1), p.100-106
• Main Authors: Willis, Andrew A., MD, Warren, Russell F., MD, Craig, Edward V., MD, Adler, Ronald S., MD, PhD, Cordasco, Frank A., MD, Lyman, Stephen, PhD, Fealy, Stephen, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement - adverse effects; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the osteoarticular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; New York City - epidemiology; Orthopedic surgery; Orthopedics; Osteoarthritis - surgery; Postoperative Complications; Prevalence; Prospective Studies; Risk Factors; Shoulder Joint - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2008.07.011

Summary This clinical study was performed to document the prevalence of deep vein thrombosis (DVT) after prosthetic shoulder replacement surgery. We prospectively followed 100 consecutive shoulder arthroplasty procedures (total shoulder replacement in 73 and hemiarthroplasty in 27) in 44 male and 56 female patients for 12 weeks (mean age, 67 years; range, 17-88 years). Risk factors for venous thromboembolic disease were assessed preoperatively and postoperatively. A 4-limb surveillance color flow Doppler ultrasound was performed at 2 days (100 patients) and 12 weeks (50 patients randomly selected) after surgery, and the presence and location of DVT were recorded. Postoperative symptomatic or fatal pulmonary emboli (PE) were also recorded. The overall prevalence of DVT was 13.0%, consisting of 13 DVTs in 12 patients. These included 6 ipsilateral and no contralateral upper extremity DVTs and 5 ipsilateral and 2 contralateral lower extremity DVTs. The prevalence of DVT was 10.0% (10/100) at day 2 after surgery and 6.0% (3/50) at week 12 after surgery. The incidence of symptomatic nonfatal PE was 2.0% (2/100), and that of fatal PE was 1.0% (1/100). Risk factors associated with venous thromboembolic disease did not reach statistical significance because of the small study population sample size. At our institution, the prevalence of DVT after reconstructive shoulder arthroplasty was 13.0%, a rate comparable to that after hip arthroplasty (10.3%) but lower than that after knee arthroplasty (27.2%). Shoulder arthroplasty surgeons should be aware of the potential risk of perioperative thromboembolic complications in both the acute and subacute postoperative periods.