Our Summary

This research paper investigates the frequency of a condition called venous thromboembolism (VTE), a blood clot that starts in a vein, in teenagers who have undergone a type of knee surgery called arthroscopy. This procedure is becoming more common in young patients, but complications, like VTE, are usually rare.

To understand more about the likelihood of VTE occurring after knee arthroscopy, the researchers examined the medical records of patients aged 19 or younger who had the procedure between 2010 and 2014 and were later diagnosed with VTE. They recorded information such as age, gender, body mass index, details about the surgery, VTE risk factors (like family history of VTE, obesity, use of oral contraceptives, and smoking), and the type and duration of treatment.

Out of 2783 patients who had knee arthroscopy during this period, seven developed VTE afterwards. These cases were made up of three males and four females, with an average age of 16.9 years. The types of knee procedures varied, and VTE was usually diagnosed about nine days after surgery. Treatment typically involved a type of medication called low-molecular-weight heparin, with some patients later switching to a drug called warfarin. Treatment lasted on average for 64 days.

The researchers found that all patients who developed VTE had at least one known risk factor for the condition, including use of oral contraceptives, smoking, obesity, a complex surgical procedure, or a surgery lasting longer than 60 minutes.

The study concludes that while VTE after knee arthroscopy in adolescents is relatively rare (occurring in about 0.25% of cases), all patients who developed the complication had at least one known risk factor for VTE.

FAQs

  1. How frequently does venous thromboembolism (VTE) occur in teenagers who have undergone knee arthroscopy?
  2. What are the risk factors for developing VTE after knee arthroscopy?
  3. What is typically the duration and type of treatment for VTE after knee arthroscopy?

Doctor’s Tip

A doctor might advise a patient undergoing arthroscopy to stay active and mobile after the procedure to reduce the risk of developing blood clots. They may also recommend wearing compression stockings and taking blood-thinning medications as prescribed to further reduce the risk of complications like VTE. Additionally, it is important for patients to inform their healthcare provider of any risk factors they may have for VTE, such as a family history of the condition or current use of oral contraceptives, to ensure proper preventive measures are taken.

Suitable For

Patients who are typically recommended arthroscopy are those who have certain knee conditions that can be diagnosed and treated through this minimally invasive procedure. These conditions may include meniscal tears, ligament injuries, cartilage damage, and inflammation. Patients who have not responded to conservative treatments like physical therapy or medication may also be recommended arthroscopy. Additionally, patients who have persistent knee pain, swelling, or limited mobility may benefit from this procedure.

Timeline

Overall timeline:

  • Patient undergoes knee arthroscopy surgery
  • VTE is diagnosed about nine days after surgery
  • Treatment with low-molecular-weight heparin and warfarin lasts for an average of 64 days

Before arthroscopy:

  • Patient decides to undergo knee arthroscopy surgery
  • Pre-operative consultations and assessments are conducted
  • Patient may be advised to stop certain medications or alter their diet
  • Surgery date is scheduled

After arthroscopy:

  • Patient wakes up from surgery in the recovery room
  • Post-operative care is provided, including pain management
  • Patient is monitored for any complications or side effects
  • Patient is discharged from the hospital with instructions for at-home care and follow-up appointments
  • Patient undergoes physical therapy and rehabilitation to aid in recovery
  • Patient may experience pain, swelling, and stiffness in the affected knee
  • Patient gradually resumes normal activities and sports with guidance from healthcare providers

What to Ask Your Doctor

  1. What is arthroscopy and why is it being recommended for my knee condition?
  2. What are the potential risks and complications associated with arthroscopy, including the risk of developing venous thromboembolism (VTE)?
  3. What are the signs and symptoms of VTE that I should watch out for after the procedure?
  4. Are there any specific risk factors that I have for developing VTE after knee arthroscopy?
  5. How will VTE be diagnosed if it occurs after the procedure?
  6. What treatment options are available for VTE, and what is the expected duration of treatment?
  7. Are there any preventive measures or medications that can reduce the risk of VTE after knee arthroscopy?
  8. How often should I follow up with my doctor after the procedure to monitor for any potential complications, including VTE?
  9. What lifestyle changes, if any, should I consider to reduce my risk of developing VTE after knee arthroscopy?
  10. Are there any specific warning signs or symptoms that I should immediately report to my doctor if I suspect I may have developed VTE after the procedure?

Reference

Authors: Murphy RF, Heyworth B, Kramer D, Naqvi M, Miller PE, Yen YM, Kocher MS, Shore BJ. Journal: J Pediatr Orthop. 2019 Mar;39(3):125-129. doi: 10.1097/BPO.0000000000000894. PMID: 30730416