title: Incidence of venous thromboembolism after elective knee arthroscopic surgery: a historical cohort study.
abstract: BACKGROUND
  The incidence of symptomatic venous thromboembolism (VTE) after knee arthroscopy is uncertain.
  
  
  OBJECTIVE
  To estimate the incidence of symptomatic VTE after arthroscopic knee surgery.
  
  
  METHODS
  In a population-based historical cohort study, all Olmsted County, MN, USA, residents undergoing a first arthroscopic knee surgery during the 18-year period of 1988-2005 were followed for incident deep venous thrombosis or pulmonary embolism. The cumulative incidence of VTE after knee arthroscopy was determined using the Kaplan-Meier product limit estimator. Patient age at surgery, sex, calendar year of surgery, body mass index, anesthesia characteristics, and hospitalization were tested as potential predictors of VTE using Cox proportional hazards modeling, both univariately and adjusted for age and sex.
  
  
  RESULTS
  Among 4833 Olmsted County residents with knee arthroscopy, 18 developed postoperative VTE, all within the first 6 weeks after surgery. The cumulative incidence rates of symptomatic VTE at 7, 14, and 35 days were 0.2%, 0.3%, and 0.4%, respectively. The hazard for postoperative VTE was significantly increased for older patient age (hazard ratio = 1.34 for each 10-year increase in patient age; P = 0.03) and hospitalization either before or after knee arthroscopy (hazard ratio = 14.1; P < 0.001).
  
  
  CONCLUSIONS
  The incidence of symptomatic VTE after arthroscopic knee surgery is very low. Older age and hospitalization are associated with increased risk. Routine prophylaxis to prevent symptomatic VTE is likely not needed in this patient population.
authors: Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. mauck.karen@mayo.edu
authors: K F
authors: KF
authors: Mauck
authors: D A
authors: DA
authors: Froehling
authors: P R
authors: PR
authors: Daniels
authors: D L
authors: DL
authors: Dahm
authors: A A
authors: AA
authors: Ashrani
authors: D J
authors: DJ
authors: Crusan
authors: T M
authors: TM
authors: Petterson
authors: K R
authors: KR
authors: Bailey
authors: J A
authors: JA
authors: Heit
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
keywords: deep venous thrombosis epidemiology; incidence; knee replacement arthroplasty; pulmonary embolism; venous thromboembolism
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