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Venous thromboembolism complications in shoulder surgery: current concepts
Michael R Mancini1, Matthew R LeVasseur2, Benjamin C Hawthorne2
1Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA mancini.michaelr@gmail.com.
Journal of ISAKOS : Joint Disorders & Orthopaedic Sports Medicine
|September 18, 2021
Summary
Venous thromboembolism (VTE) is a rare complication after shoulder surgery. Identifying patient and surgical risk factors is crucial for informed consent and optimizing VTE prevention strategies.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Patient Safety
Background:
- Venous thromboembolism (VTE) is a known complication of shoulder surgery, with reported rates varying significantly.
- Established chemical prophylactic guidelines for VTE are lacking in shoulder arthroplasty, unlike in lower extremity procedures.
- Mechanical prophylaxis is widely adopted for shoulder surgery, especially for longer operations.
Purpose of the Study:
- To review the incidence and risk factors of VTE in shoulder surgery.
- To discuss the implications for current prophylactic practices and informed consent.
- To highlight the need for further research to optimize VTE prevention.
Main Methods:
- Review of existing literature on VTE in shoulder surgery.
- Analysis of identified patient- and surgery-related risk factors.
- Comparison with VTE prophylaxis strategies in hip and knee arthroplasty.
Main Results:
- VTE incidence in shoulder arthroplasty ranges from 0.2% to 16%.
- Specific patient and surgical risk factors for VTE have been identified.
- Current treatment protocols are often extrapolated from lower extremity arthroplasty data.
Conclusions:
- Awareness and discussion of VTE risk factors are essential during the informed consent process.
- Further research with larger cohorts is needed to establish optimal VTE prevention guidelines for shoulder surgery.
- Tailoring prevention strategies based on identified risk factors may improve patient outcomes.
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