Deep vein thromboembolism after arthroscopy of the shoulder: two case reports and a review of the literature.
BACKGROUND
Deep vein thrombosis (DVT) has an incidence of 1 case per 1000 inhabitants in the general population and it is very rare after arthroscopy of the shoulder. Therefore, the current guidelines do not advise the administration of DVT prophylaxis in shoulder arthroscopy procedures.


METHODS
We describe two cases of thrombosis of the arm after shoulder arthroscopy on a total of 10.452 shoulder arthroscopies performed during a period of ten years. One of two patients was further complicated by a bilateral pulmonary microembolism. In these two clinical cases the complication developed despite the absence of risk factors such as a concomitant neoplasm, thrombophilia, smoking habit, or a long duration of the procedure.


CONCLUSIONS
The DVT after shoulder arthroscopy procedure remain a very rare complication. However, in view of the growing number of patients undergoing this procedure, this figure is expected to rise. The clinician surgeon should take in mind this possible complication that normally appears in the first 3 weeks after surgery, so to perform anti-coagulant treatment. Further clinical studies are therefore warranted to assess the true risk of VTE. In fact, the presence of "minor" predisposing factors that are not routinely studied, as well as the postoperative immobilization period, are potential risk factors that, associated with the invasiveness of the arthroscopy procedure, could trigger a thromboembolism.
Garofalo
Raffaele
R
Department of Clinical Methodology and Surgical Techniques, University of Bari, Bari, Italy.
Notarnicola
Angela
A
Moretti
Lorenzo
L
Moretti
Biagio
B
Marini
Stefania
S
Castagna
Alessandro
A
D000074:Acenocoumarol / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001132:Arm / Q000098:blood supply / Q000503:physiopathology; D001182:Arthroscopy / Q000009:adverse effects*; D001367:Axillary Vein / Q000000981:diagnostic imaging / Q000293:injuries / Q000503:physiopathology; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004487:Edema / Q000209:etiology / Q000503:physiopathology; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging; D011182:Postoperative Care / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D012785:Shoulder Joint / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D019851:Thrombophilia / Q000175:diagnosis / Q000235:genetics; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D055815:Young Adult
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D000074:Acenocoumarol