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Deep venous thrombosis and pulmonary embolism after anterior cruciate ligament reconstruction

Kraus Schmitz, J. LU orcid ; Lindgren, V. ; Janarv, P. M. ; Forssblad, M. and Stålman, A. (2019) In Bone and Joint Journal 101B(1). p.34-40
Abstract

Aims The aim of this study was to investigate the incidence, risk factors, and outcome of venous thromboembolism (VTE) following anterior cruciate ligament (ACL) reconstruction in a nationwide cohort. Patients and Methods All ACL reconstructions, primary and revision, that were recorded in the Swedish Knee Ligament Register (SKLR) between 2006 and 2013 were linked with data from the Swedish National Board of Health and Welfare. The incidence of VTE was determined by entries between the day of surgery until 90 days postoperatively based on diagnosis codes and the prescription of anticoagulants. Risk factors, outcome, and the use of thromboprophylaxis were analyzed. Descriptive statistics with multivariate analysis were used to describe... (More)

Aims The aim of this study was to investigate the incidence, risk factors, and outcome of venous thromboembolism (VTE) following anterior cruciate ligament (ACL) reconstruction in a nationwide cohort. Patients and Methods All ACL reconstructions, primary and revision, that were recorded in the Swedish Knee Ligament Register (SKLR) between 2006 and 2013 were linked with data from the Swedish National Board of Health and Welfare. The incidence of VTE was determined by entries between the day of surgery until 90 days postoperatively based on diagnosis codes and the prescription of anticoagulants. Risk factors, outcome, and the use of thromboprophylaxis were analyzed. Descriptive statistics with multivariate analysis were used to describe the findings. Results The cohort consisted of 26 014 primary and revision ACL reconstructions. There were 89 deep venous thromboses (DVTs) and 12 pulmonary emboli (PEs) with a total of 95 VTEs (0.4 %). Six patients with a PE had a simultaneous DVT. The only independent risk factor for VTE was age greater than or equal to 40 years (odds ratio 2.31, 95% confidence interval 1.45 to 3.70; p < 0.001). Thromboprophylaxis was prescribed to 9461 patients (36%) and was equally distributed between those with and those without a VTE (37.9% vs 36.4%). All patient-reported outcome measures (PROMs) one and two years postoperatively were significantly lower in those with VTE. Conclusion The incidence of VTE following ACL reconstruction is 0.4%, and the only significant risk factor is age. Patients with VTE had worse postoperative clinical outcome than patients without VTE. We recommend against the routine use of thromboprophylaxis, but it should be considered in older patients.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Bone and Joint Journal
volume
101B
issue
1
pages
34 - 40
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • scopus:85059399830
  • pmid:30601041
ISSN
2049-4394
DOI
10.1302/0301-620X.101B1.BJJ-2018-0646.R1
language
English
LU publication?
no
additional info
Publisher Copyright: © 2019 The British Editorial Society of Bone & Joint Surgery.
id
acb391ee-56b7-4f47-b3db-86c906893616
date added to LUP
2022-09-11 20:06:13
date last changed
2024-04-04 09:48:56
@article{acb391ee-56b7-4f47-b3db-86c906893616,
  abstract     = {{<p>Aims The aim of this study was to investigate the incidence, risk factors, and outcome of venous thromboembolism (VTE) following anterior cruciate ligament (ACL) reconstruction in a nationwide cohort. Patients and Methods All ACL reconstructions, primary and revision, that were recorded in the Swedish Knee Ligament Register (SKLR) between 2006 and 2013 were linked with data from the Swedish National Board of Health and Welfare. The incidence of VTE was determined by entries between the day of surgery until 90 days postoperatively based on diagnosis codes and the prescription of anticoagulants. Risk factors, outcome, and the use of thromboprophylaxis were analyzed. Descriptive statistics with multivariate analysis were used to describe the findings. Results The cohort consisted of 26 014 primary and revision ACL reconstructions. There were 89 deep venous thromboses (DVTs) and 12 pulmonary emboli (PEs) with a total of 95 VTEs (0.4 %). Six patients with a PE had a simultaneous DVT. The only independent risk factor for VTE was age greater than or equal to 40 years (odds ratio 2.31, 95% confidence interval 1.45 to 3.70; p &lt; 0.001). Thromboprophylaxis was prescribed to 9461 patients (36%) and was equally distributed between those with and those without a VTE (37.9% vs 36.4%). All patient-reported outcome measures (PROMs) one and two years postoperatively were significantly lower in those with VTE. Conclusion The incidence of VTE following ACL reconstruction is 0.4%, and the only significant risk factor is age. Patients with VTE had worse postoperative clinical outcome than patients without VTE. We recommend against the routine use of thromboprophylaxis, but it should be considered in older patients.</p>}},
  author       = {{Kraus Schmitz, J. and Lindgren, V. and Janarv, P. M. and Forssblad, M. and Stålman, A.}},
  issn         = {{2049-4394}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{34--40}},
  publisher    = {{British Editorial Society of Bone & Joint Surgery}},
  series       = {{Bone and Joint Journal}},
  title        = {{Deep venous thrombosis and pulmonary embolism after anterior cruciate ligament reconstruction}},
  url          = {{http://dx.doi.org/10.1302/0301-620X.101B1.BJJ-2018-0646.R1}},
  doi          = {{10.1302/0301-620X.101B1.BJJ-2018-0646.R1}},
  volume       = {{101B}},
  year         = {{2019}},
}