Editorial Commentary: Prophylaxis Against Deep Venous Thrombosis Should Be the Norm After Knee Arthroscopy

Knee arthroscopy has low complication rates overall, and most complications are not overly disabling. Yet one of the most concerning complications is venous thromboembolism, and pulmonary embolism (PE), in particular. The combination of low rate of venous thromboembolism in knee arthroscopy but high potential cost in the event of PE makes for a challenging risk-benefit analysis in the decision for whether to use thromboprophylaxis. Research is inherently difficult due to the infrequency of deep venous thrombosis and PE, leaving orthopaedic surgeons to fill in the gaps with clinical judgement. Risk stratification based on patient risk factors (e.g., oral contraceptives, renal disease, cardiovascular disease) and specific surgical procedure (e.g., meniscectomy, anterior cruciate ligament reconstruction) are important to define the highest-risk patients that may warrant stronger anticoagulation. Yet even in low-risk patients, given the potential severity of a PE and safety of aspirin, surgeons should consider aspirin as thromboprophylaxis.