title: Deep venous thrombosis after surgery for Achilles tendon rupture: a provoked transient event with minor long-term sequelae.
abstract: BACKGROUND
  Deep venous thrombosis (DVT) occurs frequently in patients undergoing orthopedic surgery, but there is a lack of knowledge regarding long-term sequelae of DVT after different types of surgical procedures.
  
  
  OBJECTIVE
  To describe the long-term effect of symptomatic (SDVT) and asymptomatic (ADVT) deep venous thrombosis on venous function and subsequent incidence of post-thrombotic syndrome (PTS) in patients who have undergone surgery for Achilles tendon rupture.
  
  
  METHODS
  This observational follow-up study includes 83 patients with postoperative DVT, examined after a mean of 7 years. There were two series of patients: 45 with SDVT and 38 with ADVT. In both series, more than 90% of the DVTs were limited to calf veins. Follow-up examinations comprised color duplex ultrasonography (CDU), strain-gauge plethysmography (SGP), clinical examination including scoring for venous disease and questionnaires for quality of life (QOL).
  
  
  RESULTS
  A mild degree of PTS was found in 11% of the patients: 13% in SDVT and 8% in ADVT patients. The rate of recurrent ipsilateral DVT was 2%. Deep venous reflux was more common in patients with SDVT than in ADVT patients (84% vs. 55%, P < 0.01). Only a few patients had plethysmograpically abnormal findings without difference between the two groups.
  
  
  CONCLUSIONS
  DVT after surgery for Achilles tendon rupture consists mainly of distal DVTs and are associated with a low risk for PTS. Deep venous reflux was more common in SDVT than in ADVT patients, probably as an effect of larger DVTs in the former group.
authors: Section of Clinical Physiology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Sweden. lena.m.persson@sodersjukhuset.se
authors: L M
authors: LM
authors: Persson
authors: L J
authors: LJ
authors: Lapidus
authors: G
authors: G
authors: Lärfars
authors: S
authors: S
authors: Rosfors