Abstract
Prospectively assess the incidence of deep venous thrombosis (DVT) using Doppler Ultrasound, in patients receiving elective hip arthroscopy without pharmacologic/mechanical prophylaxis. One hundred and fifteen consecutive patients (mean 35.4 years, SD = 10.3) underwent elective hip arthroscopy. Patients with previous major risk factors for DVT were excluded. Signs/symptoms of DVT/pulmonary embolism were assessed at 2-week post-operatively. A bilateral whole leg Duplex color (Doppler) Ultrasonography was scheduled between 10- and 22-day post-op. The primary outcome was frequency of DVT. Secondary outcomes assessed surgical risk factors. One hundred and ten patients (mean = 34.3 years, SD = 10.1) did not get a DVT. Five patients (mean = 43.8 years, SD = 12.1) were diagnosed with a DVT, 2- to 22-day post-operatively. All DVT patients received arthroscopy in the supine position (n = 76), versus no patients in the lateral position (n = 39). Average traction time was 38 (SD = 4) and 61 (SD = 4) minutes for patients with and without a DVT, respectively. All other a priori defined risk factors were similar. Four out of five patients presented with symptoms of a DVT, confirmed by ultrasound. One patient was without symptoms/clinical findings. Four patients had a DVT restricted to the calf veins; one patient had involvement of the popliteal vein. No patients had proximal extension into the thigh or pelvis. No pulmonary emboli were suspected or occurred. The incidence of deep venous thromboembolism is 4.3%. The majority of patients had symptomatic and distal venous thromboembolic events. This study provides supportive evidence that routine prophylaxis and/or screening may not be necessary in low risk patients undergoing elective hip arthroscopy.
Highlights
Hip arthroscopy has been used to treat various disorders of the hip including labral pathology, femoro-acetabular impingement and early arthritis
Retrospective case series and database studies have reported the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) ranging from 0% to 3.7% [8,9,10,11]
The primary objective of this study was to determine the rate of deep vein thrombosis in patients with no known risk factors for thromboembolic events, undergoing elective hip arthroscopy
Summary
Hip arthroscopy has been used to treat various disorders of the hip including labral pathology, femoro-acetabular impingement and early arthritis. There have been several reports of thromboembolic events in both elective and urgent hip arthroscopy procedures [1,2,3]. Published reviews of hip arthroscopic procedures have identified deep venous thrombosis (DVT) and pulmonary embolism (PE) as recognized complications [4,5,6,7]. Retrospective case series and database studies have reported the incidence of DVT and PE ranging from 0% to 3.7% [8,9,10,11]. There has been one retrospective study that attempted to identify DVT and PE as part of a quality assurance protocol [12]. This study examined for DVTs using Doppler
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