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The Incidence of Deep Venous Thrombosis After Arthroscopic Knee Surgery

John W. Jaureguito, MD, Ann E. Greenwald, MS, Joseph F. Wilcox, MD^,, Lonnie E. Paulos, MD^,|| and Thomas D. Rosenberg, MD

Orthopedic Specialty Hospital, Salt Lake City, Utah, Georgia
Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia

Presented at the American Academy of Orthopaedic Surgeons annual meeting, Atlanta, Georgia, February 1996.

Address correspondence to Joseph F. Wilcox, MD, 1705 Briarlake Circle, Decatur, GA 30033

|| Address reprint requests to Lonnie E. Paulos, MD, The Orthopedic Specialty Hospital, 5848 South 300 East, Salt Lake City, UT 84107

We retrospectively reviewed the records of 2050 arthroscopic knee surgeries performed at The Orthopedic Specialty Hospital from January 1993 to December 1994. The number of clinically detected deep venous thromboses, with confirmation by duplex ultrasonography, was determined. Prospectively, preoperative and postoperative duplex ultrasonographic images were completed on 239 patients divided into 2 groups: those undergoing nonligament, intraarticular arthroscopic surgery (N = 131) and those undergoing arthroscopically assisted ligament surgery and extraarticular or osteotomy surgery (N = 108). For the retrospective study, the incidence of deep venous thrombosis was 0.24%. Prospectively, seven total deep venous thromboses were identified (rate, 2.9%), with five being identified within 8 days of surgery in asymptomatic patients (rate, 2.1%). There were no statistically significant associations or correlations between the development of deep venous thrombosis and patient personal data or surgical variables, respectively. The difference in the rate of deep venous thrombosis between the two prospective groups was not statistically significant; however, patients who had more invasive surgery tended to be at higher risk for developing deep venous thrombosis. A cost-benefit analysis did not support the routine use of duplex ultrasonography to detect deep venous thrombosis in patients undergoing arthroscopic knee surgery.

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