title: A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction.
abstract: Venous thromboembolism, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is a serious complication after operations involving the lower extremities, and it can be fatal. However, few reports have described the incidence of PE and its associated risk factors after arthroscopic knee surgery. We present a case of bilateral massive PE of the main pulmonary arteries and DVT detected on multi-detector row computed tomography after arthroscopic multiple knee ligament reconstruction. Our patient was asymptomatic despite having several risk factors for thromboembolic events (43 years of age, a long operation time, obesity, and diabetes mellitus) and receiving no pharmacologic thromboembolic prophylaxis. Although fatality due to PE is relatively uncommon, when a patient has several risk factors for PE, perioperative thromboprophylaxis should be considered. Level of evidence IV.
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Junsei
authors.initials: J
authors.lastname: Takigami
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. hussy@med.osaka-cu.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamasaki
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Shozaburo
authors.initials: S
authors.lastname: Terai
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D058070:Asymptomatic Diseases; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery; D008403:Mass Screening; D017888:Medial Collateral Ligament, Knee / Q000293:injuries / Q000601:surgery*; D061330:Multidetector Computed Tomography; D061646:Operative Time; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D000072229:Posterior Cruciate Ligament Reconstruction; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D019651:Plastic Surgery Procedures; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Arthroscopy; Deep venous thrombosis (DVT); Multi-detector row computed tomography (MDCT); Multiple knee ligament reconstruction; Pulmonary embolism (PE); Thromboprophylaxis