Venous thromboembolism after hip arthroscopy: a systematic review of incidence, risk factors, and international guidelines

TL;DR

This review examines how common blood clots are after hip surgery, identifies risk factors, and compares global guidelines for prevention.

Contribution

The study provides a systematic review of VTE incidence and risk factors after hip arthroscopy, highlighting international guideline discrepancies.

Findings

The pooled VTE incidence after hip arthroscopy is 0.656%, with DVT at 0.441% and PE at 0.216%.

Risk factors include obesity, oral contraceptive use, age ≥45, and coagulopathy.

Most guidelines recommend risk-based thromboprophylaxis rather than routine use for standard-risk patients.

Abstract

This review aims to systematically evaluate the incidence, risk factors, and international guideline discrepancies for venous thromboembolism (VTE) following hip arthroscopy (HA).

A search of four databases from the inception to April 20, 2025, identified studies reporting VTE outcomes post-HA. Relevant practice guideline recommendations were concurrently analyzed.

Twenty-one studies encompassing 135,377 patients and five clinical guidelines were included. Female patients constituted 91,013 cases (67.2%). The mean patient age was 37.08 years; however, the average follow-up duration was limited to 3.7 months, which may be a study limitation. Pooled incidence rates were: deep vein thrombosis (DVT) 0.441%, pulmonary embolism (PE) 0.216%, and overall VTE 0.656%. The majority of studies were Level IV evidence (57%), with Level III evidence comprising 33%. Identified risk factors for post-HA VTE included obesity, oral contraceptive use, ≥45 years, overweight status, coagulopathy, and arteriovenous anomalies. The reported VTE incidence ranged from 0% to 6.94%. International guidelines vary, but most advocate for risk-stratified thromboprophylaxis.

The incidence of VTE following hip arthroscopy is low. Routine pharmacological thromboprophylaxis may not be necessary for standard-risk patients. However, high-risk individuals warrant personalized prophylaxis regimens, with pharmacological prophylaxis when clinically indicated based on risk assessment.

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