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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Contralateral deep venous thrombosis after hip arthroscopy
Michael J Alaia1, Andrey Zuskov, Roy I Davidovitch
1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York 10003, USA. alaiamj@gmail.com
Orthopedics
|September 30, 2011
Summary
Hip arthroscopy is generally safe, but a rare case of deep venous thrombosis (DVT) occurred postoperatively. Awareness of this risk, especially with oral contraceptive use, is crucial for physicians.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
Background:
- Hip arthroscopy is a common procedure for hip conditions with a generally low complication rate.
- Postoperative deep venous thrombosis (DVT) or venous thromboembolism is considered a rare complication following hip arthroscopy.
- Pharmacologic prophylaxis is not routinely administered after hip arthroscopy due to the perceived low risk.
Observation:
- A 33-year-old woman developed contralateral thigh pain and swelling 13 days after hip arthroscopy.
- Diagnostic ultrasonography confirmed acute DVTs in the left common femoral, superficial femoral, and popliteal veins.
- The patient had a history of oral contraceptive use and underwent a routine hip arthroscopy involving axial traction.
Findings:
- The patient's thrombophilia workup was negative, suggesting other contributing factors.
- The authors hypothesize that oral contraceptive use, axial traction, and pelvic forces during surgery contributed to the DVT.
- This case highlights a rare but serious postoperative complication following hip arthroscopy.
Implications:
- Physicians should maintain awareness of the potential for DVT after hip arthroscopy, even in routine cases.
- Risk factors such as oral contraceptive use may increase susceptibility to postoperative venous thromboembolism.
- Further consideration of prophylactic measures in specific patient populations may be warranted.
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