From the Department of Orthopaedics, Vanderbilt University Medical Center, Nashville, TN (Wollenman, Cox, Schoenecker, and Wright), the Department of Pathology, Microbiology, and Immunology, the Department of Pediatrics, the Center for Bone Biology, and the Department of Pharmacology, Vanderbilt University, Nashville, TN (Schoenecker).
J Am Acad Orthop Surg. 2024 Sep 1;32(17):e850-e860. doi: 10.5435/JAAOS-D-24-00232. Epub 2024 Jul 16.
Venous thromboembolism (VTE), comprising pulmonary embolism and deep vein thrombosis, is one of the most common complications after knee arthroscopy. Sequelae of VTE include VTE recurrence, postthrombotic syndrome, and potential for loss of limb or life. Given the increasing volume of knee arthroscopy procedures worldwide and the considerable morbidity and mortality associated with VTE, it is important to prevent, diagnose, and treat VTEs efficiently and effectively. Risk factors such as history of VTE, family history of VTE, genetic coagulopathy, oral contraceptive use, cancer history, and old age increase the risk of postoperative VTE and warrant consideration of prophylaxis. Diagnosis and treatment should be initiated rapidly in the setting of concerning symptoms and positive imaging diagnosis, respectively. The purpose of this review was to provide a framework to individualized VTE risk, weigh prophylaxis options, expedite diagnostic pathways, and implement outpatient treatment algorithms.
静脉血栓栓塞症（VTE）包括肺栓塞和深静脉血栓形成，是膝关节镜检查后最常见的并发症之一。VTE 的后遗症包括 VTE 复发、血栓后综合征以及肢体或生命丧失的潜在风险。鉴于全球膝关节镜检查手术量的增加，以及 VTE 相关的相当大的发病率和死亡率，有效预防、诊断和治疗 VTE 非常重要。VTE 病史、VTE 家族史、遗传性凝血功能障碍、口服避孕药使用、癌症病史和年龄较大等危险因素会增加术后 VTE 的风险，需要考虑预防措施。在出现相关症状和阳性影像学诊断的情况下，应分别迅速开始诊断和治疗。本综述的目的是提供一个框架，以确定 VTE 风险的个体差异，权衡预防选择，加快诊断途径，并实施门诊治疗方案。
