Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
권호 표지
DOI QR코드

DOI QR Code

The Incidence of Venous Thromboembolism Following Shoulder Surgery: A Pilot Study

  • Cho, Chul-Hyun (Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Jang, Hyung-Gyu (Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Park, Ui-Jun (Department of Vascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Hyoung Tae (Department of Vascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine)
  • 투고 : 2016.06.28
  • 심사 : 2016.09.01
  • 발행 : 2017.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

키워드

참고문헌

  1. Anakwe RE, Middleton SD, Beresford-Cleary N, McEachan JE, Talwalkar SC. Preventing venous thromboembolism in elective upper limb surgery. J Shoulder Elbow Surg. 2013;22(3):432-8. https://doi.org/10.1016/j.jse.2012.10.033
  2. Saleh HE, Pennings AL, ElMaraghy AW. Venous thromboembolism after shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg. 2013;22(10):1440-8. https://doi.org/10.1016/j.jse.2013.05.013
  3. Dattani R, Smith CD, Patel VR. The venous thromboembolic complications of shoulder and elbow surgery: a systematic review. Bone Joint J. 2013;95(1):70-4. https://doi.org/10.2106/JBJS.K.01406
  4. Hoxie SC, Sperling JW, Cofield RH. Pulmonary embolism following rotator cuff repair. Int J Shoulder Surg. 2008;2(3):49-51. https://doi.org/10.4103/0973-6042.42576
  5. Jameson SS, James P, Howcroft DW, et al. Venous thromboembolic events are rare after shoulder surgery: analysis of a national database. J Shoulder Elbow Surg. 2011;20(5):764-70. https://doi.org/10.1016/j.jse.2010.11.034
  6. Kuremsky MA, Cain EL Jr, Fleischli JE. Thromboembolic phenomena after arthroscopic shoulder surgery. Arthroscopy. 2011;27(12):1614-9. https://doi.org/10.1016/j.arthro.2011.06.026
  7. Manaqibwala MI, Ghobrial IE, Curtis AS. Upper extremity thrombosis presenting as medial elbow pain after shoulder arthroscopy. Case Rep Orthop. 2014;2014:653146.
  8. Ojike NI, Bhadra AK, Giannoudis PV, Roberts CS. Venous thromboembolism in shoulder surgery: a systematic review. Acta Orthop Belg. 2011;77(3):281-9.
  9. Randelli P, Castagna A, Cabitza F, Cabitza P, Arrigoni P, Denti M. Infectious and thromboembolic complications of arthroscopic shoulder surgery. J Shoulder Elbow Surg. 2010;19(1):97-101. https://doi.org/10.1016/j.jse.2009.04.009
  10. Saseedharan S, Bhargava S. Upper extremity deep vein thrombosis. Int J Crit Illn Inj Sci. 2012;2(1):21-6. https://doi.org/10.4103/2229-5151.94891
  11. Willis AA, Warren RF, Craig EV, et al. Deep vein thrombosis after reconstructive shoulder arthroplasty: a prospective observational study. J Shoulder Elbow Surg. 2009;18(1):100-6. https://doi.org/10.1016/j.jse.2008.07.011
  12. Bongiovanni SL, Ranalletta M, Guala A, Maignon GD. Case reports: heritable thrombophilia associated with deep venous thrombosis after shoulder arthroscopy. Clin Orthop Relat Res. 2009;467(8):2196-9. https://doi.org/10.1007/s11999-009-0895-6
  13. Cortes ZE, Hammerman SM, Gartsman GM. Pulmonary embolism after shoulder arthroscopy: could patient positioning and traction make a difference? J Shoulder Elbow Surg. 2007;16(2):e16-7. https://doi.org/10.1016/j.jse.2006.05.009
  14. Creighton RA, Cole BJ. Upper extremity deep venous thrombosis after shoulder arthroscopy: a case report. J Shoulder Elbow Surg. 2007;16(1):e20-2. https://doi.org/10.1016/j.jse.2006.04.002
  15. Edgar R, Nagda S, Huffman R, Namdari S. Pulmonary embolism after shoulder arthroscopy. Orthopedics. 2012;35(11):e1673-6. https://doi.org/10.3928/01477447-20121023-31
  16. Garofalo R, Notarnicola A, Moretti L, Moretti B, Marini S, Castagna A. Deep vein thromboembolism after arthroscopy of the shoulder: two case reports and a review of the literature. BMC Musculoskelet Disord. 2010;11:65. https://doi.org/10.1186/1471-2474-11-65
  17. Hariri A, Nourissat G, Dumontier C, Doursounian L. Pulmonary embolism following thrombosis of the brachial vein after shoulder arthroscopy. A case report. Orthop Traumatol Surg Res. 2009;95(5):377-9. https://doi.org/10.1016/j.otsr.2009.03.016
  18. Kang S, Chung PH, Kim JP, Kim YS, Lee HM, Jang HG. Pulmonary embolism after screw fixation for a greater tubercle fracture of humerus. Clin Should Elbow. 2014;17(4):201-4. https://doi.org/10.5397/cise.2014.17.4.201
  19. Gwark JY, Koh JS, Park HB. Pulmonary embolism after arthroscopic rotator cuff repair: a case report. Clin Should Elbow. 2014;17(1):31-5. https://doi.org/10.5397/cise.2014.17.1.31
  20. Kim SJ, Yoo KY, Lee HG, Kim WM, Jeong CW, Lee HJ. Fatal pulmonary embolism caused by thrombosis of contralateral axillary vein after arthroscopic right rotator cuff repair: A case report. Korean J Anesthesiol. 2010;59 Suppl:S172-5. https://doi.org/10.4097/kjae.2010.59.S.S172
  21. Yamamoto T, Tamai K, Akutsu M, Tomizawa K, Sukegawa T, Nohara Y. Pulmonary embolism after arthroscopic rotator cuff repair: a case report. Case Rep Orthop. 2013;2013:801752.
  22. Di Nisio M, Van Sluis GL, Bossuyt PM, Buller HR, Porreca E, Rutjes AW. Accuracy of diagnostic tests for clinically suspected upper extremity deep vein thrombosis: a systematic review. J Thromb Haemost. 2010;8(4):684-92. https://doi.org/10.1111/j.1538-7836.2010.03771.x
  23. Chin EE, Zimmerman PT, Grant EG. Sonographic evaluation of upper extremity deep venous thrombosis. J Ultrasound Med. 2005;24(6):829-38; quiz 839-40. https://doi.org/10.7863/jum.2005.24.6.829
  24. Sun Y, Chen D, Xu Z, et al. Incidence of symptomatic and asymptomatic venous thromboembolism after elective knee arthroscopic surgery: a retrospective study with routinely applied venography. Arthroscopy. 2014;30(7):818-22. https://doi.org/10.1016/j.arthro.2014.02.043