Page 9 - ISAKOS 2020 Newsletter Volume 2

More than half of the PPI and OPI populations presented with at least one classic risk factor (patella alta, trochlear dysplasia, increased quadriceps vector, lateral tilt). In the PPI group, 37% of patients had at least two risk factors, whereas in the OPI group, 33% of patients had three risk factors. None of the patients presented with all four anatomical risk factors. The author concluded that patients presenting with patellofemoral instability (PPI and OPI) display similar ligament stiffness patterns and that patients with PFP and PPI showed higher ligament stiffness as compared with patients with OPI.
Unexpectedly High Incidence of Venous Thromboembolism After Arthroscopic ACLR
Masaki Nagashima, Toshiro Otani, Kenichiro Takeshima, Hirokyuki Seki, Masanori Nakayama, Nobuto Origuchi, Ken Ishii
Prospective Observational Study
The objectives of this study were to investigate the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after anterior cruciate ligament reconstruction (ACLR) using ultrasonography (US) and contrast-enhanced CT (CECT) without pharmacological prophylaxis and to identify the risk factors for DVT. A prospective observational study of 55 consecutive Japanese patients undergoing ACLR
(including 10 revision procedures) was performed. All operations were performed by one experienced surgeon with use of a tourniquet and a single-bundle hamstring autograft. US of the leg veins was performed on the sixth or seventh postoperative day. When a patient was diagnosed with DVT, CECT was performed to detect PE. Clinical factors were then compared between patients with and without DVT. After ACLR, DVT was detected in 9 patients (16.4%) and CECT showed that 4 of them had PE (representing an incidence of at least 7.3%). All patients were asymptomatic. The mean age was significantly higher for patients with DVT than for those without DVT (41.9 ± 15.7 years compared with 28.2 ± 14.2 years; p = 0.012). There were no significant differences between patients with and without DVT terms of other clinical factors, including sex, BMI, current smoking status, preoperative Lysholm score, time interval from injury to ACLR, type of procedure (primary or revision), preoperative knee pain, operative and tourniquet times, and meniscal repair. The authors concluded that the incidences of DVT and PE after ACLR were unexpectedly high and might suggest a need for thromboprophylaxis. As advanced age was identified as the risk factor for DVT in this study, patients with this risk factor should be considered for pharmacological prophylaxis after ACLR.
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ISAKOS NEWSLETTER 2020: VOLUME II 7