# Pulmonary Embolism Following Quadriceps Tendon Repair With Tourniquet Use Despite Adequate Thromboprophylaxis: A Case Report

## TL;DR

A man with obesity developed a pulmonary embolism after quadriceps tendon surgery, even with blood clot prevention measures.

## Contribution

This case report highlights the risk of VTE after tendon repair and the need for tailored thromboprophylaxis.

## Key findings

- A 53-year-old man with obesity developed PE after quadriceps tendon repair with tourniquet use.
- Standard thromboprophylaxis may be insufficient for high-risk patients undergoing tendon surgery.
- Tourniquet use and patient-specific factors may increase VTE risk in tendon repair.

## Abstract

Venous thromboembolism (VTE) is a recognized complication following orthopaedic surgery of the lower limb, but its incidence after quadriceps tendon repair remains poorly described. We report the case of a 53-year-old man (BMI 42 kg/m²) with morbid obesity who developed acute pulmonary embolism (PE) following quadriceps tendon repair performed with tourniquet assistance, despite receiving extended perioperative thromboprophylaxis with tinzaparin. This case highlights the interplay between tourniquet use, patient-specific risk factors (obesity, delayed surgery, and reduced mobility), and the adequacy of standard-duration prophylaxis. We also discuss why existing arthroplasty data may not directly apply to tendon repair surgery and the need for individualized prophylaxis strategies in high-risk patients.