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关节镜下前交叉韧带重建围手术期深静脉血栓形成的相关因素。

Factors associated with perioperative deep vein thrombosis in arthroscopic anterior cruciate ligament reconstruction.

机构信息

Department of Orthopedic Surgery, Tottori University, 36-1 Nishicho, Yonago City, Tottori, 683-8504, Japan.

Sports Medical Center, Tottori University, 36-1 Nishicho, Yonago City, Tottori, 683-8504, Japan.

出版信息

J Orthop Sci. 2023 Sep;28(5):1041-1045. doi: 10.1016/j.jos.2022.06.003. Epub 2022 Jul 14.

DOI:10.1016/j.jos.2022.06.003
PMID:35842268
Abstract

BACKGROUND

Anterior cruciate ligament reconstruction (ACLR) is reportedly associated with a higher incidence of deep vein thrombosis (DVT) incidence than other arthroscopic surgical procedures. The aim of this study is to retrospectively investigate the incidence and type of DVT and evaluate the relationship between DVT and risk factors among all patients who underwent ACLR under uniform conditions consisting of mechanical prophylaxis, no medical prophylaxis, and preoperative and postoperative lower extremity venous ultrasonography.

METHODS

Of the 114 patients who underwent arthroscopic primary ACLR at our hospital who did not have a compound ligament injury or revision surgery, 112 patients were included. Two patients were not examined. DVT evaluation consisted of whole-leg ultrasonography at 1 week after surgery. We evaluated age, sex, body mass index, comorbidities, operative time, tourniquet time, presence of concurrent surgery (meniscus repair/resection or osteochondral column grafting), and non-weight-bearing status at 1 week after surgery as risk factors for DVT.

RESULTS

DVT was found in 33 (29.5%) of 112 patients. Of these, 22 (19.6%) had distal DVT and 11 (9.8%) had proximal DVT. Non-weight-bearing status at 1 week after surgery was a statistically significant risk factor for proximal DVT (P = .034).

CONCLUSIONS

Non-weight-bearing status is an independent risk factor for DVT, suggesting that early weight bearing may reduce the occurrence of DVT.

摘要

背景

据报道,前交叉韧带重建(ACLR)的深静脉血栓(DVT)发生率高于其他关节镜手术。本研究旨在回顾性调查所有接受 ACLR 患者的 DVT 发生率和类型,并评估 DVT 与危险因素之间的关系,这些患者在统一的条件下接受 ACLR,包括机械预防、无药物预防以及术前和术后下肢静脉超声检查。

方法

在我院行关节镜初次 ACLR 的 114 例患者中,无复合韧带损伤或翻修手术的 112 例患者纳入研究。2 例患者未进行检查。DVT 评估包括术后 1 周的全腿超声检查。我们评估了年龄、性别、体重指数、合并症、手术时间、止血带时间、同期手术(半月板修复/切除或骨软骨柱移植)以及术后 1 周非负重状态作为 DVT 的危险因素。

结果

112 例患者中发现 DVT33 例(29.5%)。其中,远端 DVT 22 例(19.6%),近端 DVT 11 例(9.8%)。术后 1 周非负重状态是近端 DVT 的统计学显著危险因素(P =.034)。

结论

非负重状态是 DVT 的独立危险因素,提示早期负重可能会降低 DVT 的发生。

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