title: Venous thromboembolism after shoulder arthroplasty: a systematic review.
abstract: BACKGROUND
  Shoulder arthroplasty (SA) is a common orthopaedic procedure that is being performed on a more and more frequent basis. Venous thromboembolism (VTE) as a complication has received little attention when it occurs after SA. The literature lacks a comprehensive summary of the incidence, risk factors, and prophylaxis of VTE in this population of patients.
  
  
  METHODS
  Literature on VTE after SA has been identified from 5 scientific databases: EMBASE, MEDLINE, Web of Science, CINAHL, and Cochrane. All primary full-text articles reporting at least 1 case of deep vein thrombosis or pulmonary embolism after SA were included. Articles were critically appraised and systematically analyzed to determine the incidence, risk factors, thromboprophylaxis, diagnosis, and management of VTE after SA.
  
  
  RESULTS
  This study included 14 articles. The reported incidence of VTE after SA was 0.2% to 16.0%. The most serious risk factors for development of VTE included history of VTE, thrombophilia, major surgery, advanced age, current malignant disease, immobility, and bed confinement. Diagnosis was typically determined by duplex scan and chest computed tomography scan. VTE prophylaxis was used in 6 (43%) of the included studies, with the ideal method of prophylaxis unknown.
  
  
  CONCLUSIONS
  Although variability exists in the reported incidence of VTE, surgeons should still be aware of the potential for this serious complication after SA. We recommend assessing the risk factors and estimating the VTE risk status for all patients undergoing SA. The ideal method of prophylaxis for this population of patients remains unknown and should be investigated in future high-quality clinical studies.
authors: Consultant Orthopaedic Surgeon, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.
authors: Hosny E
authors: HE
authors: Saleh
authors: Amanda L
authors: AL
authors: Pennings
authors: Amr W
authors: AW
authors: ElMaraghy
mesh_terms: D001178:Arthroplasty / Q000009:adverse effects*; D014943:Global Health; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000601:surgery*; D011183:Postoperative Complications; D012785:Shoulder Joint / Q000601:surgery*; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology*
keywords: Arthroplasty; Level IV; Systematic Review; deep vein thrombosis; pulmonary embolism; shoulder; systematic review; venous thromboembolism