A rare case of pulmonary embolus after arthroscopic meniscus surgery

Area of Science:

• Orthopedic Surgery
• Vascular Medicine
• Sports Medicine

Background:

• Consensus exists for thromboprophylaxis in major orthopedic procedures like joint replacement.
• Widespread agreement on thromboprophylaxis for minor arthroscopic surgery is lacking.
• Combined oral contraceptive pills (COCPs) are a known risk factor for thromboembolism.

Observation:

• A healthy 20-year-old female collegiate athlete developed deep vein thrombosis (DVT) and pulmonary embolism (PE) after arthroscopic meniscectomy.
• The patient had no significant risk factors apart from prior COCP use.
• Symptoms of DVT appeared 20 hours post-surgery, confirmed by ultrasound.
• PE symptoms emerged one week later, diagnosed via CT angiography.

Findings:

• Thromboembolic complications, including DVT and PE, can occur after seemingly minor arthroscopic procedures.
• Even in the absence of multiple risk factors, patients may be susceptible to venous thromboembolism (VTE).
• The case highlights the potential for serious vascular events following knee arthroscopy.

Implications:

• Broadened use of thromboprophylaxis may be warranted for patients undergoing arthroscopic surgery, especially those with any identifiable risk factors.
• Proactive VTE prophylaxis could prevent severe complications like DVT and PE in at-risk populations.
• This case underscores the importance of individualized risk assessment in perioperative care for orthopedic patients.