Summary
Deep Vein Thrombosis Prophylaxis in Patients who Undergo Knee Arthroscopy
Abstract
Objectives: Knee arthroscopy is one of the most common procedures performed by orthopaedic surgeons. A potentially life-threatening complication following this procedure is deep vein thrombosis (DVT). DVT prophylaxis can be achieved both mechanically (e.g. compression stockings) and chemically (e.g. aspirin, anticoagulants, and factor Xa inhibitors). Currently, there are no standardized guidelines for DVT prophylaxis following knee arthroscopy. This purpose of this study was to summarize how DVT prophylaxis is employed for patients who undergo knee arthroscopy and to provide a universal suggestion for DVT prophylaxis in the setting of knee arthroscopy.
Materials And Methods
PubMed, Embase, and Cochrane Library were searched for studies published between 1998 and March 2023 according to PRISMA guidelines. Studies were included if they evaluated DVT prophylaxis regimens in patients of any age who underwent knee arthroscopy. Studies not written in English, analyzed animals or cadavers, did not directly evaluate patients undergoing knee arthroscopy, or did not study DVT prophylaxis were excluded.
Results
The initial search identified 300 studies, 15 of which met inclusion criteria and were included in the study. These 15 studies examined methods including compression stockings (2 of 18; 11%), aspirin (1 of 18; 6%), factor Xa inhibitors (2 of 18; 11%), low molecular weight heparin (12 of 18; 67%), and neuromuscular electrical stimulation (1 of 18; 6%). Overall, 7 of 15 (47%) studies recommended DVT prophylaxis in all patients, and 3 (20%) studies supported its use for high-risk patients. Five (33%) studies did not support DVT prophylaxis, citing a low incidence of post-operative DVT.
Conclusion
Compression stockings, aspirin, factor Xa inhibitors, and low molecular weight heparin (LMWH) were identified as possible DVT prophylaxis methods for patients undergoing knee arthroscopy. For high-risk patients, factor Xa inhibitors and LMWH drugs are a safe and effective way to prevent the development of a DVT.