Al-Khatib Yousef, Kumar Manoj, Alwaheed Malak, Berhanu Bisrat Girma, Al-Khatib Omran, Askar Mohamad, Lakdawala Ayaz
Trauma and Orthopaedics, Stoke Mandeville Hospital, Aylesbury, UK.
Trauma and Orthopaedics, George Eliot Hospital, Nuneaton, UK.
Qatar Med J. 2025 Jun 9;2025(2):42. doi: 10.5339/qmj.2025.42. eCollection 2025.
Venous thromboembolism (VTE) following anterior cruciate ligament (ACL) arthroscopic reconstructions is reported to occur at a rate of 0.5%-2.2%, with very few studies investigating the use of thromboprophylaxis. This study aims to investigate the incidence of VTE post ACL reconstruction surgery while proposing a thromboprophylaxis regimen.
A single-center retrospective cross-sectional observational study was conducted over 8 years and 8 months. The primary outcome was the incidence of symptomatic VTE up to 12 weeks post-operatively. Secondary outcome measures were the rate of major bleeding incidents, wound infections, and delayed wound healing. Enoxaparin 40 mg subcutaneously once daily and thromboembolic deterrent stockings were given to all patients for 14 days post-operatively. Total anesthetic time, total surgical time, and tourniquet time were also recorded. Only patients who underwent arthroscopic ACL reconstruction were included, with all conservatively managed patients being excluded.
A total of 155 patients were identified, and none had a symptomatic VTE up to 12 weeks post-operatively. None of the patients experienced delayed wound healing, wound infections, or major bleeding incidences up to 12 weeks post-operatively. Average total anesthetic time was 145 (±24.8) minutes, average total surgical time was 122 (±25.3) minutes, and average Tourniquet time was 82.1 (±23.8) minutes.
We demonstrated a 0% rate of clinically symptomatic VTE without complications such as delayed wound healing or major bleeding incidents. This is the only study proposing a combined regimen of both chemical and mechanical thromboprophylaxis after ACL reconstruction. Further research involving larger groups would be required to assess the effectiveness of this approach and to compare the effectiveness of mechanical and chemical thromboprophylaxis after ACL reconstruction.
据报道，前交叉韧带（ACL）关节镜重建术后静脉血栓栓塞（VTE）的发生率为0.5%-2.2%，很少有研究探讨血栓预防措施的使用。本研究旨在调查ACL重建手术后VTE的发生率，并提出一种血栓预防方案。
进行了一项为期8年零8个月的单中心回顾性横断面观察研究。主要结局是术后12周内有症状VTE的发生率。次要结局指标是大出血事件、伤口感染和伤口愈合延迟的发生率。所有患者术后14天每天皮下注射一次40mg依诺肝素，并使用血栓栓塞防护袜。还记录了总麻醉时间、总手术时间和止血带时间。仅纳入接受关节镜ACL重建的患者，所有保守治疗的患者均被排除。
共确定了155例患者，术后12周内均无有症状VTE。术后12周内，没有患者出现伤口愈合延迟、伤口感染或大出血事件。平均总麻醉时间为145（±24.8）分钟，平均总手术时间为122（±25.3）分钟，平均止血带时间为82.1（±23.8）分钟。
我们证明临床有症状VTE的发生率为0%，且无伤口愈合延迟或大出血事件等并发症。这是唯一一项提出ACL重建后化学和机械血栓预防联合方案的研究。需要进行涉及更大样本量的进一步研究来评估这种方法的有效性，并比较ACL重建后机械和化学血栓预防的有效性。
