Authors' Reply

Abstract

We appreciate the concerns Dr. Anand raised in his letter on our latest study published in the July 2014 issue.The 4-day average is the average discharge time point for the patients included in our study. For patients with cruciate ligament reconstruction, the operative knee was, under most circumstances, fixed in a brace. Postoperative mobilization normally started after the anesthesia wore off. Historically, the DVT incidence has been quite high at our institution after arthroscopic surgery. We used venography, which is the gold standard for DVT diagnosis, to detect DVT. Ultrasonography was also applied in our center for the validation of the DVT diagnosis. Ultrasonography is a noninvasive and handy method for DVT detection; however, it is not as accurate or sensitive as venography, especially when it comes to distal DVT like that located in the gastrocnemius muscular branch.Racial variation might partly explain the high DVT incidence. It has been suggested that the incidence of DVT in the Asian population is much higher than previously reported. However, we now believe that the DVT incidence and prophylaxis are more institution sensitive because the incidence of DVT is quite consistent in our own center. DVT prophylaxis is not yet routinely applied in our center in patients undergoing arthroscopic procedures. Physical prophylaxis such as a pneumatic tourniquet is provided, and voluntary contraction of the lower extremity muscles is encouraged. For these patients, only definitive DVT diagnosis signifies the need for thrombosis-related treatment. We appreciate the concerns Dr. Anand raised in his letter on our latest study published in the July 2014 issue. The 4-day average is the average discharge time point for the patients included in our study. For patients with cruciate ligament reconstruction, the operative knee was, under most circumstances, fixed in a brace. Postoperative mobilization normally started after the anesthesia wore off. Historically, the DVT incidence has been quite high at our institution after arthroscopic surgery. We used venography, which is the gold standard for DVT diagnosis, to detect DVT. Ultrasonography was also applied in our center for the validation of the DVT diagnosis. Ultrasonography is a noninvasive and handy method for DVT detection; however, it is not as accurate or sensitive as venography, especially when it comes to distal DVT like that located in the gastrocnemius muscular branch. Racial variation might partly explain the high DVT incidence. It has been suggested that the incidence of DVT in the Asian population is much higher than previously reported. However, we now believe that the DVT incidence and prophylaxis are more institution sensitive because the incidence of DVT is quite consistent in our own center. DVT prophylaxis is not yet routinely applied in our center in patients undergoing arthroscopic procedures. Physical prophylaxis such as a pneumatic tourniquet is provided, and voluntary contraction of the lower extremity muscles is encouraged. For these patients, only definitive DVT diagnosis signifies the need for thrombosis-related treatment. The Incidence of DVTArthroscopyVol. 30Issue 11PreviewI read with interest the article entitled “Incidence of symptomatic and asymptomatic venous thromboembolism after elective knee arthroscopic surgery: A retrospective study with routinely applied venography” by Sun et al. in the July 2014 issue. I was quite frankly surprised by the high incidence of asymptomatic DVT. Full-Text PDF