Fatal Pulmonary Embolism in a Polytraumatized Patient Following Hip Arthroscopy

Abstract

Prophylaxis of venous thromboembolic disease for patients undergoing orthopedic procedures remains a controversial topic. Deep venous thrombosis and pulmonary embolism are well studied in the total joint arthroplasty population, as are the various options for prevention and treatment. In the past few years, hip arthroscopy has enjoyed increasingly broader indications and applications, especially in patients who have suffered trauma to the hip. Current studies of hip arthroscopy, however, have not reported venous thromboembolic disease as a complication. No guidelines exist for venous thromboembolic disease prophylaxis associated with hip arthroscopy, perhaps because the need for such guidelines has not materialized. This article describes a case of fatal pulmonary embolism associated with hip arthroscopy after traumatic injury. A literature review reveals that this is the first report of this complication and that no guidelines exist regarding prophylaxis of venous thromboembolic disease in hip arthroscopy. Surgeons performing this technique should make treatment decisions on an individualized basis, considering patient- and injury-specific factors.