Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlePerioperative Thromboprophylaxis Is Associated With Lower Risk of Venous Thromboembolism After Knee Arthroscopy
Section snippets
Database
This retrospective cross-sectional study used the Mariner Patient Records Database (www.pearldiver.com, Colorado Springs, CO), a subscription-based health records dataset. The Mariner dataset is publicly available and contains more than 100 million records from 2010 through 2020 for orthopaedic patients insured through private agencies, Medicare, Medicaid, and self-pay populations. Patient records can be queried using Current Procedural Terminology (CPT) codes and International Classification
Results
A total of 718,289 patients met inclusion criteria. Approximately 28,311 patients were excluded for a previous diagnosis of VTE, hypercoagulable disorder, or surgical procedure for infection or concurrent fracture. Patient demographics are shown in Table 2. A total of 10,769 (1.5%) patients were prescribed and filled prescriptions for perioperative thromboprophylaxis, including aspirin (n = 5,353, 0.7%), LMWH (n = 4,563, 0.6%) or factor Xa inhibitors (apixaban only) (n = 947, 0.1%). A total of
Discussion
In this large, population-based study, we observed an overall rate of symptomatic VTE of 1.06% within 90 days after arthroscopic knee surgery. Procedure type and complexity was significantly associated with the rate of postoperative symptomatic VTE. The risk of experiencing postoperative VTE was also significantly impacted by OCP use and medical comorbidities, including obesity, renal disease and CHF. Furthermore, we found that patients who receive and fill perioperative thromboprophylaxis
Conclusions
While the overall rate of symptomatic VTE following knee arthroscopy remains low, procedure types that are more complex and generally require restrictive rehabilitation protocols, OCP use, obesity, renal disease, and CHF are associated with increased odds of postoperative VTE. Conversely, the use of perioperative thromboprophylaxis is associated with significantly lower VTE risk.
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Increased Age, Operative Time, ASA Classification, Functional Dependency, and Comorbidity Burden Are Risk Factors for Adverse Events After Meniscectomy and Meniscus Repair: 10-Year Analysis of 64,223 Patients
2023, Arthroscopy - Journal of Arthroscopic and Related SurgeryEditorial Commentary: Prophylaxis Against Deep Venous Thrombosis Should Be the Norm After Knee Arthroscopy
2022, Arthroscopy - Journal of Arthroscopic and Related Surgery
See commentary on page 3192
The authors report the following potential conflicts of interest or sources of funding: A.L.Z. reported consultant for Stryker and DePuy Mitek, outside the submitted work. C.B.M. reported consultant for Stryker, Conmed, and Tornier; grants from Aesculap, Samumed, Zimmer, and Conmed; and royalties from Conmed, outside the submitted work. B.T.F. reported grants/grants pending from National Institutes of Health and Orthopaedic Research and Education Foundation; suture anchor patent pending; and stock/stock options from Bioniks and Kaliber AI, outside the submitted work. D.A.L. reports consultant for Vericel and AlloSource; grants from AANA, American Orthopaedic Society for Sports Medicine (AOSSM), Arthritis Foundation, AANA – Arthroscopy Research Grant; AOSSM – Young Investigator Award, Arthritis Foundation – research funding outside the submitted work; and patent pending for suture anchor device, outside the submitted work. ICMJE author disclosure forms are available for this article online, as supplementary material.