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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2017

01-01-2017 | Knee

A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction

Authors: Junsei Takigami, Yusuke Hashimoto, Shinya Yamasaki, Shozaburo Terai, Hiroaki Nakamura

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2017

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Abstract

Venous thromboembolism, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is a serious complication after operations involving the lower extremities, and it can be fatal. However, few reports have described the incidence of PE and its associated risk factors after arthroscopic knee surgery. We present a case of bilateral massive PE of the main pulmonary arteries and DVT detected on multi-detector row computed tomography after arthroscopic multiple knee ligament reconstruction. Our patient was asymptomatic despite having several risk factors for thromboembolic events (43 years of age, a long operation time, obesity, and diabetes mellitus) and receiving no pharmacologic thromboembolic prophylaxis. Although fatality due to PE is relatively uncommon, when a patient has several risk factors for PE, perioperative thromboprophylaxis should be considered.
Level of evidence IV.
Literature
1.
go back to reference Demers C, Marcoux S, Ginsberg J et al (1998) Incidence of venographically proved deep vein thrombosis after knee arthroscopy. Arch Intern Med 158:45–47CrossRef Demers C, Marcoux S, Ginsberg J et al (1998) Incidence of venographically proved deep vein thrombosis after knee arthroscopy. Arch Intern Med 158:45–47CrossRef
2.
go back to reference Hetsroni I, Lyman S, Do H et al (2011) Symptomatic pulmonary embolism after outpatient arthroscopic procedures of the knee. J Bone Joint Surg Br 93-B:47–51CrossRef Hetsroni I, Lyman S, Do H et al (2011) Symptomatic pulmonary embolism after outpatient arthroscopic procedures of the knee. J Bone Joint Surg Br 93-B:47–51CrossRef
3.
go back to reference Marlovits S, Striessnig G, Schuster R et al (2007) Extended-duration thromboprophylaxis with enoxaparin after arthroscopic surgery of the anterior cruciate ligament: a prospective, randomized, placebo-controlled study. Arthroscopy 23:696–702CrossRefPubMed Marlovits S, Striessnig G, Schuster R et al (2007) Extended-duration thromboprophylaxis with enoxaparin after arthroscopic surgery of the anterior cruciate ligament: a prospective, randomized, placebo-controlled study. Arthroscopy 23:696–702CrossRefPubMed
4.
go back to reference Mook WR, Miller MD, Diduch DR et al (2009) Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg Am 91-A:2946–2957CrossRef Mook WR, Miller MD, Diduch DR et al (2009) Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg Am 91-A:2946–2957CrossRef
5.
go back to reference Piovella F, Wang C-J, Lu H et al (2005) Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost 3:2664–2670CrossRefPubMed Piovella F, Wang C-J, Lu H et al (2005) Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost 3:2664–2670CrossRefPubMed
6.
go back to reference Reigstad O, Grimsgaard C et al (2006) Complications in knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 14:473–477CrossRefPubMed Reigstad O, Grimsgaard C et al (2006) Complications in knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 14:473–477CrossRefPubMed
7.
go back to reference Sun Y, Chen D, Xu Z et al (2014) Incidence of symptomatic and asymptomatic venous thromboembolism after elective knee arthroscopic surgery: a retrospective study with routinely applied venography. Arthroscopy 30:818–822CrossRefPubMed Sun Y, Chen D, Xu Z et al (2014) Incidence of symptomatic and asymptomatic venous thromboembolism after elective knee arthroscopic surgery: a retrospective study with routinely applied venography. Arthroscopy 30:818–822CrossRefPubMed
8.
go back to reference Yngve F-Y, Francis CW, Johanson NA et al (2012) Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 141:278S–325S Yngve F-Y, Francis CW, Johanson NA et al (2012) Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 141:278S–325S
Metadata
Title
A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction
Authors
Junsei Takigami
Yusuke Hashimoto
Shinya Yamasaki
Shozaburo Terai
Hiroaki Nakamura
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3466-7

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