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Reverse Total Shoulder Arthroplasty
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Venothromboembolism following shoulder arthroscopy: a systematic review
Jacob J Triplet1, Hayden B Schuette1, Adnan N Cheema1
1Mayo Clinic, Rochester, MN, USA.
JSES Reviews, Reports, and Techniques
|August 17, 2023
Summary
Venous thromboembolic events (VTEs) are rare after shoulder arthroscopy, with an overall incidence of 0.21%. This systematic review highlights the low risk but emphasizes surgeon awareness of potential complications and current prophylaxis strategies.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Medical Research Methodology
Background:
- Venous thromboembolic events (VTEs) pose risks following orthopedic surgery, though less common in upper extremity procedures.
- The precise incidence of VTEs after shoulder arthroscopy may be underestimated in existing literature.
- This study focuses on VTE incidence specifically after arthroscopic shoulder procedures, excluding large database studies.
Purpose of the Study:
- To systematically review and report the incidence of VTEs following shoulder arthroscopic procedures.
- To provide an updated understanding of VTE risks in this specific patient population.
- To exclude data from large surgical or insurance claim databases to ensure data integrity.
Main Methods:
- A systematic review was conducted following PRISMA guidelines.
- Multiple databases were searched from inception to September 1, 2021, for English-language studies.
- Studies were screened by two independent reviewers, excluding large database studies.
Main Results:
- Thirteen studies involving 32,407 patients were included.
- The overall incidence of VTEs was 0.21% (DVT 0.15%, PE 0.08%).
- For arthroscopic rotator cuff repair, the overall VTE rate was 1.04% (DVT 0.71%, PE 0.37%).
Conclusions:
- Symptomatic VTEs are infrequent after shoulder arthroscopy but remain a potential complication.
- Risk factors like operative time and obesity may influence VTE occurrence, though data are conflicting.
- For low-risk patients, early mobilization appears as effective as chemical prophylaxis in preventing VTEs.
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