Thromboprophylaxis in Knee Arthroscopy Patients: Revisiting Values and Preferences
Authors: Russell D. Hull
Journal: Annals of Internal Medicine (2008)

Editorials15 July 2008Thromboprophylaxis in Knee Arthroscopy Patients: Revisiting Values and PreferencesRussell D. Hull, MBBS, MScRussell D. Hull, MBBS, MScFrom Foothills Hospital, Calgary, Alberta T2N 2T9, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-2-200807150-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The most common orthopedic operation worldwide is knee arthroscopy. The best-practice guidelines for thromboprophylaxis for knee arthroscopy patients remain to be determined. Because of uncertainty about the perioperative and postoperative risk for deep venous thrombosis (DVT), physicians have been noncommittal about the need for thromboprophylaxis in such patients, especially because diagnostic arthroscopy and arthroscopy-assisted knee surgery are mostly performed in young patients. This debate about the need for thromboprophylaxis is important, because approximately 3.5 million knee arthroscopies are performed per year globally (1, 2). Although clinical venous thromboembolism (VTE) is uncommon and deaths are rare, this huge volume of surgery ...References1. Italian National Health Service Registry, 2005. Rome: Ministero della Salute; 2008. Accessed at www.ministerosalute.it/dettaglio/phPrimoPianoNew.jsp on 13 June 2008. Google Scholar2. Hoppener MR, Ettema HB, Henny CP, Verheyen CC, Büller HR. Low incidence of deep vein thrombosis after knee arthroscopy without thromboprophylaxis: a prospective cohort study of 335 patients. Acta Orthop. 2006;77:767-71. [PMID: 17068708] CrossrefMedlineGoogle Scholar3. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S-400S. [PMID: 15383478] CrossrefMedlineGoogle Scholar4. Cardiovascular Disease Educational and Research Trust. Cyprus Cardiovascular Disease Educational and Research Trust. European Venous Forum. International Surgical Thrombosis Forum. International Union of Angiology. Union Internationale de Phlébologie. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol. 2006;25:101-61. [PMID: 16763532] MedlineGoogle Scholar5. Wirth T, Schneider B, Misselwitz F, Lomb M, Tüylü H, Egbring R, et al. Prevention of venous thromboembolism after knee arthroscopy with low-molecular weight heparin (reviparin): Results of a randomized controlled trial. Arthroscopy. 2001;17:393-9. [PMID: 11288011] CrossrefMedlineGoogle Scholar6. Michot M, Conen D, Holtz D, Erni D, Zumstein MD, Ruflin GB, et al. Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery: A randomized trial of prophylaxis with low—molecular weight heparin. Arthroscopy. 2002;18:257-63. [PMID: 11877611] CrossrefMedlineGoogle Scholar7. Marlovits S, Striessnig G, Schuster R, Stocker R, Luxl M, Trattnig S, et al. Extended-duration thromboprophylaxis with enoxaparin after arthroscopic surgery of the anterior cruciate ligament: a prospective, randomized, placebo-controlled study. Arthroscopy. 2007;23:696-702. [PMID: 17637403] CrossrefMedlineGoogle Scholar8. Camporese G, Bernardi E, Prandoni P, Noventa F, Verlato F, Simioni P, et al; KANT (Knee Arthroscopy Nadroparin Thromboprophylaxis) Study Group. Low-molecular-weight heparin versus compression stockings for thromboprophylaxis after knee arthroscopy. A randomized trial. Ann Intern Med. 2008;149:73-82. LinkGoogle Scholar9. Kakkar VV, Howe CT, Flanc C, Clarke MB. Natural history of postoperative deep-vein thrombosis. Lancet. 1969;2:230-2. [PMID: 4184105] CrossrefMedlineGoogle Scholar10. Moser KM, LeMoine JR. Is embolic risk conditioned by location of deep venous thrombosis? Ann Intern Med. 1981;94:439-44. [PMID: 7212500] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Russell D. Hull, MBBS, MScAffiliations: From Foothills Hospital, Calgary, Alberta T2N 2T9, Canada.Disclosures:Consultancies: Sanofi-Aventis. Honoraria: Sanofi-Aventis, LEO Pharma, GlaxoSmithKline, Bayer, Pfizer. Grants received: Sanofi-Aventis.Corresponding Author: Russell D. Hull, MBBS, MSc, Foothills Hospital, South Tower, Room 601, 1403 29 Street NW, Calgary, Alberta T2N 2T9, Canada; e-mail, [email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLow-Molecular-Weight Heparin versus Compression Stockings for Thromboprophylaxis after Knee Arthroscopy Giuseppe Camporese , Enrico Bernardi , Paolo Prandoni , Franco Noventa , Fabio Verlato , Paolo Simioni , Kadimashi Ntita , Giovanna Salmistraro , Christos Frangos , Franco Rossi , Rosamaria Cordova , Francesca Franz , Pietro Zucchetta , Dimitrios Kontothanassis , and Giuseppe Maria Andreozzi , for the KANT (Knee Arthroscopy Nadroparin Thromboprophylaxis) Study Group* Is Low-Molecular-Weight Heparin Suitable in All Patients Undergoing Knee Arthroplasty? 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Yusen, MD, MPH, for the EXCLAIM (Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization) study*Low-molecular-weight heparin for thromboprophylaxisCurrent World LiteratureIs Low-Molecular-Weight Heparin Suitable in All Patients Undergoing Knee Arthroplasty?Giuseppe Camporese, MD, Franco Noventa, MD, and Enrico Bernardi, MD, PhD 15 July 2008Volume 149, Issue 2Page: 137-139KeywordsArthroscopyHemorrhageKneesLow molecular weight heparinMedical risk factorsProphylaxisPulmonary embolismRandomized trialsSafetySurgery ePublished: 15 July 2008 Issue Published: 15 July 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...