Arthroscopy, deep vein thrombosis and pulmonary embolism

Abstract

Recent studies have documented the utility of using heparin, and especially low molecular heparin, for the prevention of venous thromboembolism (VTE) in surgical patients. However, this approach might not be essential in individuals at low VTE risk and following minor surgical interventions. Arthroscopic surgery might be considered minor surgery but at times is performed in individuals with established risk factors for VTE. Furthermore, some arthroscopic procedures include tissue damage that is not necessarily trivial, and in addition, documented cases of VTE events, some of them even fatal, appeared in the literature. By now, most researchers agree that it is essential to adopt an individualized risk stratification to single out individuals who might benefit from a prophylactic approach that might include early mobilization, and mechanical devices, as well as heparins. Thus, despite the clearly low prevalence of documented VTE following arthroscopic surgery, one might not accept potential life threatening events following these relatively low risk procedures. Therefore, patients might benefit from a personalized risk-benefit equation before each particular intervention.