Arterial complications, venous thromboembolism and deep venous thrombosis prophylaxis after anterior cruciate ligament reconstruction: A systematic review  

作　　者：Rob Paulus Augustinus Janssen Max Reijman Daan Martijn Janssen Jan Bernardus Antonius van Mourik 

机构地区：[1]Department of Sports Medicine and Orthopaedic Surgery, Máxima Medical Center [2]Department of Orthopaedics and Trauma, Máxima Medical Center [3]Department of Orthopaedic Surgery Erasmus MC, University Medical Center Rotterdam

出　　处：《World Journal of Orthopedics》2016年第9期604-617,共14页世界骨科杂志（英文版）

摘　　要：AIM To summarize the current knowledge on vascular complications and deep venous thrombosis(DVT) prophylaxis after anterior cruciate ligament(ACL) reconstruction.METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. MEDLINE, EMBASE, Cochrane,Web of Science, CINAHL, PubMed publisher, and Google scholar medical literature databases were searched up to November 10, 2015. Any arthroscopic surgical method of primary or revision intra-articular ACL reconstruction of all graft types in humans was included. A risk of bias assessment was determined.RESULTS Fourty-seven studies were included in the review.Pseudaneurysms were the most frequently reported arterial complication after ACL reconstruction, irrespective of graft type or method of graft fixation with an incidence of 0.3%. The time to diagnosis of arterial complications after ACL reconstruction varied from days to mostly weeks but even years. After ACL reconstruction without thromboprophylaxis, the incidence of DVT was 9.7%, of which 2.1% was symptomatic. The incidence of pulmonary embolism was 0.1%. Tourniquet time > 2 h was related to venous thromboembolism.Thromboprophylaxis is indicated in patients with risk factors for venous thromboembolism.CONCLUSION After ACL reconstruction, the incidence of arterial complications,symptomatic DVT and pulmonary embolism was 0.3%, 2.1% and 0.1% respectively. Arterial complications may occur with all types of arthroscopic ACL reconstruction, methods of graft fixation as well as any type of graft. Patients considered to be at moderate or high risk of venous thromboembolism should routinely receive thromboprophylaxis after ACL reconstruction.AIM To summarize the current knowledge on vascular complications and deep venous thrombosis(DVT) prophylaxis after anterior cruciate ligament(ACL) reconstruction.METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. MEDLINE, EMBASE, Cochrane,Web of Science, CINAHL, PubMed publisher, and Google scholar medical literature databases were searched up to November 10, 2015. Any arthroscopic surgical method of primary or revision intra-articular ACL reconstruction of all graft types in humans was included. A risk of bias assessment was determined.RESULTS Fourty-seven studies were included in the review.Pseudaneurysms were the most frequently reported arterial complication after ACL reconstruction, irrespective of graft type or method of graft fixation with an incidence of 0.3%. The time to diagnosis of arterial complications after ACL reconstruction varied from days to mostly weeks but even years. After ACL reconstruction without thromboprophylaxis, the incidence of DVT was 9.7%, of which 2.1% was symptomatic. The incidence of pulmonary embolism was 0.1%. Tourniquet time > 2 h was related to venous thromboembolism.Thromboprophylaxis is indicated in patients with risk factors for venous thromboembolism.CONCLUSION After ACL reconstruction, the incidence of arterial complications,symptomatic DVT and pulmonary embolism was 0.3%, 2.1% and 0.1% respectively. Arterial complications may occur with all types of arthroscopic ACL reconstruction, methods of graft fixation as well as any type of graft. Patients considered to be at moderate or high risk of venous thromboembolism should routinely receive thromboprophylaxis after ACL reconstruction.

关 键 词：Anterior CRUCIATE ligament reconstruction ARTERIAL complication PSEUDOANEURYSM Venous THROMBOEMBOLISM Pulmonary EMBOLISM THROMBOPROPHYLAXIS 

分 类 号：R687.4[医药卫生—骨科学]