The incidence of venous thromboembolism in patients undergoing arthroscopic anterior cruciate ligament repair: A proposed thromboprophylaxis regimen

TL;DR

This study found no cases of blood clots after ACL surgery when using a combination of medication and compression stockings.

Contribution

The paper proposes a new combined chemical and mechanical thromboprophylaxis regimen for ACL surgery.

Findings

No symptomatic VTE occurred in 155 patients using the proposed regimen.

No major bleeding, wound infections, or delayed healing were observed.

Average surgical and anesthetic times were recorded for reference.

Abstract

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.

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