Venous thromboembolism prophylaxis in arthroscopic surgery

The prophylaxis and epidemiology of venous thromboembolism (VTE) following major orthopaedic procedures has been widely discussed in the world literature. Significantly less attention in the recent years has been paid to antithrombotic prophylaxis following arthroscopic procedures. In the past few years numerous controversies have developed as a result of contradictory guidelines advocated by various centres. Clinical studies involving prospective patient groups result in guidelines being published by orthopaedic associations. The guidelines issued by the Ame-rican College of Chest Physicians (ACCP) are the most influential. The latest edition of the guidelines was published in 2012. The National Institute for Health and Clinical Excellence (NICE) is a British centre which issues guidelines for antithrombotic prophylaxis. The latest version of the guidelines is the Clinical Guidelines (CG) 92, dated 2010. Polish guidelines were developed by a working group headed by Prof. Krystyna Zawilska. The Polish Society of Orthopaedics and Traumatology (PSOT) has not endorsed or recommended the guidelines put forward by the Working Group in 2012, so the PSOT guidelines are valid regarding orthopaedics and arthroscopic procedures. The comparison of international and Polish guidelines indicates a considerable discrepancy between the approaches to antithrombotic prophylaxis in arthroscopic procedures. From the viewpoint of an orthopaedist it is most important to select a prophylactic procedure appropriate for a specific patient. It is necessary to explain the need of prophylaxis to the patient, assess the risk factors of thrombosis and employ reliable tools, such as Wells' score. Pharmacological prophylaxis is well-known and widely used in arthroscopic procedures in Polish centres. However, it is also important to implement mechanical prophylactic measures, which are neglected or used to a limited extent in numerous centres. In recent years, American researchers conducted studies of large groups of patients with regard to the prophylaxis and incidence of VTE following arthroscopic procedures of the knee, hip and shoulder. The incidence of VTE following knee, hip and shoulder arthroscopy was 0.42%, 3.7% and 0.31%, respectively. The findings of the study support the validity of the guidelines issued by the American College of Chest Physicians in 2012.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

More peer-reviewed studies in Klinische Studien.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →