Document Detail


Deep venous thrombosis after knee arthroscopy: a systematic review and meta-analysis.
MedLine Citation:
PMID:  24581264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To establish a contemporary literature-based estimate of the incidence of deep venous thrombosis (DVT) after knee arthroscopic surgery.
METHODS: We performed a systematic review and meta-analysis of the English language literature to assess the efficacy of prophylaxis to prevent DVT after knee arthroscopic surgery. Only randomized controlled trials (RCTs) or prospective studies were considered. Studies were excluded if they were not original prospective studies concerning DVT detected by imaging after knee arthroscopic surgery. We calculated pooled proportions of postoperative DVT and proximal DVT.
RESULTS: Nine prospective uncontrolled studies and 4 RCTs were retrieved. Within them, the populations given low-molecular-weight heparin (LMWH) to prevent DVT had a 0.1% to 11.9% incidence of DVT, with an overall 36 DVTs identified (4 proximal), averaging 1.8%. One hundred thirty-six DVTs (29 proximal) were indicated in the populations without prophylaxis, and the DVT incidence varied from 1.8% to 41.2%, averaging 6.8%. Of the RCTs, the pooled risk ratio for DVT to develop was 0.180 (range, 0.065 to 0.499) for those who had LMWH as prophylaxis. An absolute risk reduction of 1.2%--from 1.5% to 0.3%--for the development of proximal DVT was observed.
CONCLUSIONS: Compared with patients who did not receive prophylaxis, the pooled risk ratio for the development of DVT was 0.18 for those who had LMWH prophylaxis. The incidence of proximal DVT is very low after arthroscopic surgery regardless of receiving prophylaxis (4 of 2,184) or not (29 of 1,814). The rate of proximal DVT in total DVT occurrence can be markedly reduced from 21.3% (29 of 136) to 11.1% (4 of 36).
LEVEL OF EVIDENCE: Level IV. This study is a meta-analysis of RCTs and a systematic review of Level IV studies.
Authors:
Ye Sun; Dongyang Chen; Zhihong Xu; Dongquan Shi; Jin Dai; Jianghui Qin; Jizhen Qin; Qing Jiang
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  30     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-03-03     Completed Date:  2014-04-16     Revised Date:  2014-08-01    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-12     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use*
Arthroscopy / adverse effects*
Heparin, Low-Molecular-Weight / therapeutic use*
Humans
Incidence
Knee Joint / surgery*
Prospective Studies
Randomized Controlled Trials as Topic
Risk
Venous Thrombosis / epidemiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight
Comments/Corrections
Comment In:
Arthroscopy. 2014 Jul;30(7):780   [PMID:  24951354 ]
Arthroscopy. 2014 Jul;30(7):780   [PMID:  24951355 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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