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viernes, 16 de abril de 2010

Deep vein thromboembolism after arthroscopy of the shoulder: two case reports and a review of the literature

Deep vein thromboembolism after arthroscopy of the shoulder: two case reports and a review of the literature

BMC Musculoskeletal Disorders 2010, 11:65doi:10.1186/1471-2474-11-65

Published: 8 April 2010

Abstract (provisional)

Background

Deep vein thrombosis (DVT) has an incidence of 1 case per 1000 inhabitants in the general population and it is very rare after arthroscopy of the shoulder. Therefore, the current guidelines do not advise the administration of DVT prophylaxis in shoulder arthroscopy procedures. Cases presentation: We describe two cases of thrombosis of the arm after shoulder arthroscopy on a total of 10.452 shoulder arthroscopies performed duringa period of ten years. One of two patients was further complicated by a bilateral pulmonary microembolism. In these two clinical cases the complication developed despite the absence of risk factors such as a concomitant neoplasm, thrombophilia, smoking habit, or a long duration of the procedure.

Conclusions

The DVT after shoulder arthroscopy procedure remain a very rare complication. However, in view of the growing number of patients undergoing this procedure, this figure is expected to rise. The clinician surgeon should take in mind this possibile complication that normally appears in the first 3 weeks after surgery, so to perform anti-coagulant treatment. Further clinical studies are therefore warranted to assess the true risk of VTE. In fact, the presence of "minor" predisposing factors that are not routinely studied, as well as the postoperative immobilization period, are potential risk factors that, associated with the invasiveness of the arthroscopy procedure, could trigger a thromboembolism.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production. 

Fuente:  BMC Musculoskeletal Disorders

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