title: Deep venous thrombosis and pulmonary embolism after knee arthroscopy in athletes carrying the thrombophilic factor lupus anticoagulant.
abstract: In patients undergoing arthroscopic knee surgery, deep venous thrombosis and pulmonary embolism are rare and there is not clear indication as to the necessity of thromboprophylactic treatment in these patients. However, the role of coagulation disorders in thrombotic events following arthroscopy is unknown. We report 2 cases of massive deep venous thrombosis and pulmonary embolism after knee arthroscopy in athletes carrying the thrombophilic factor lupus anticoagulant, but with no personal or familial history of thrombotic diseases. A few days after the arthroscopic intervention, both patients presented with deep venous thrombosis and 1 developed a severe pulmonary embolism. Blood examination showed that both athletes were lupus anticoagulant-positive. This is the first description of an association between venous thromboembolism, knee arthroscopy, and a prothrombotic condition. This report suggests that screening for hypercoagulability might be useful in athletes undergoing even minimally invasive orthopaedic surgery and that in cases of venous thromboembolism after knee arthroscopy, a prothrombotic disorder should be suspected.
authors.affiliation: Department of Orthopaedics, A. Gemelli University Hospital, Università Cattolica del Sacro Cuore School of Medicine, Rome, Italy. enricopola@hotmail.com
authors.forename: Enrico
authors.initials: E
authors.lastname: Pola
authors.forename: Andrea
authors.initials: A
authors.lastname: Flex
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Papaleo
authors.forename: Eleonora
authors.initials: E
authors.lastname: Gaetani
authors.forename: Antonio
authors.initials: A
authors.lastname: Delcogliano
authors.forename: Paolo
authors.initials: P
authors.lastname: Pola
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000097:blood* / Q000209:etiology*; D013177:Sports; D020246:Venous Thrombosis / Q000097:blood* / Q000209:etiology*
chemical_list: D016682:Lupus Coagulation Inhibitor