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A Successful Collaborative Approach to the Perioperative Management After Hip Arthroscopy of a Patient with
Ali Parsa1,2, Mark R Nazal1, John W Stelzer1
1Department of Orthopaedic Surgery, Sports Medicine, Massachusetts General Hospital, Partners Heath System, Boston, Massachusetts.
Case:
We report on a patient with heterozygous prothrombin G20210A mutation (PTM) and a history of venous thromboembolism (VTE) after knee arthroscopy, who was undergoing hip arthroscopy. This common mutation has an overall prevalence of 2.0% and results in a 280% to 420% likelihood of thrombosis compared to patients without the mutation.
Conclusions:
Hip arthroscopy is associated with a low risk of VTE with currently no guidelines for thromboprophylaxis. Patients should be managed in relation to their risk factors utilizing a collaborative, individualized approach. Treatment with short-term low-molecular-weight heparin resulted in no thromboembolism at 18-month follow-up for this patient with PTM.
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