The risk of venous thromboembolism in non-large-joint surgeries

The risk of venous thromboembolism, particularly deep venous thrombosis, after knee arthroscopy, surgically assisted arthroscopy, or treatment of lower extremity fracture may be substantial in patients with factors known to increase the risk of postoperative thromboembolism. Few prospective studies have examined the effect of prophylaxis in these patient populations. However, results suggest that routine administration of a low-molecular-weight heparin reduces the rate of deep venous thrombosis in such patients. Additional clinical studies are necessary to determine whether the benefits of prophylaxis outweight its risk and whether it is cost-effective. Until such data are available, risk for deep venous thrombosis must be assessed in all patients undergoing an orthopedic procedure. Thrompboprophylaxis with pharmacologic agents may be considered in those at high risk.