title: Deep vein thrombosis in arthroscopic surgery and chemoprophylaxis recommendation in an Asian population.
abstract: BACKGROUND
  There are currently no guidelines supporting the use of routine chemoprophylaxis to prevent deep vein thrombosis (DVT) in arthroscopic surgery. Studies and meta-analysis show opposing views on its routine use in arthroscopy. This study aimed to examine the incidence of DVT in a prospective cohort of knee arthroscopy and knee arthroplasty patients, and to analyse the risk factors contributing to DVT.
  
  
  METHODS
  All patients scheduled to undergo knee arthroscopy or arthroplasty over a two-year period were included. A standardised regimen of postoperative mechanical prophylaxis and rehabilitation was applied to all patients. Only patients who were postoperatively symptomatic were referred for ultrasonography. DVT incidence was calculated, and univariate and multivariate analyses of the risk factors were performed.
  
  
  RESULTS
  The overall incidence of DVT was 0.5% among the 1,410 arthroscopy patients and 3.1% among the 802 arthroplasty patients. The incidence of proximal DVT among the arthroscopy and arthroplasty patients was 0.4% and 1.1%, respectively. Multivariate analysis showed that age was the only significant predictor of DVT incidence. Using the receiver operating characteristic method, the cut-off age for the arthroscopy and arthroplasty patients was 52 years, while that for the arthroscopy patients only was 40 years (increased risk of DVT: 5.46 and 6.44 times, respectively; negative predictive value: 99.7% and 99.8%, respectively).
  
  
  CONCLUSIONS
  DVT incidence among Asian arthroplasty and arthroscopy patients remains low, even without chemoprophylaxis. Since age was found to be a significant risk factor for DVT, DVT prophylaxis can be considered for patients in high-risk age groups.
authors.affiliation: Department of Orthopaedics, Changi General Hospital, Singapore.
authors.forename: Kuei Siong Andy
authors.initials: KS
authors.lastname: Yeo
authors.affiliation: Department of Orthopaedics, Changi General Hospital, Singapore.
authors.forename: Wen Siang Kevin
authors.initials: WS
authors.lastname: Lim
authors.affiliation: Department of Orthopaedics, Changi General Hospital, Singapore.
authors.forename: Yee Han Dave
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001178:Arthroplasty; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D044466:Asian People; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000517:prevention & control; D012046:Rehabilitation; D012307:Risk Factors; D012846:Singapore; D020246:Venous Thrombosis / Q000209:etiology*
keywords: Asian; DVT; arthroplasty; arthroscopy; chemoprophylaxis