The incidence of deep venous thrombosis before arthroscopy among patients suffering from high-energy knee trauma.

PURPOSE: The purpose of the present study was to analyse the incidence of deep venous thrombosis (DVT) before knee arthroscopy in patients who had sustained high-energy knee injuries.

METHOD: This study included 64 patients who underwent arthroscopic knee surgery as a result of injury from a traffic accident or a high fall. Venography was performed on the injured leg of each patient before arthroscopy. The patients were divided into two groups based on whether they had DVT. Correlation analysis was performed to determine the factors associated with DVT.

RESULTS

A total of 32 (50 %) of the 64 patients had venographic evidence of DVT. Of these DVTs, seven were proximal (10.9 %). The D-dimer (DD) level was significantly higher in the DVT group, especially among the patients whose symptoms had persisted for more than 10 days. DVT is difficult to diagnose solely based on clinical symptoms, as some patients are symptomatic while others exhibit symptoms that could be attributed to trauma.

CONCLUSIONS

The incidence of DVT before knee arthroscopy in patients with high-energy knee injuries was 50 %, and the prevalence of proximal DVT was 10.9 %. DD is a sensitive marker for DVT. No patient developed DVT with a DD level lower than 0.8 mg/L, but those with DD level higher than 1.5 mg/L had a much higher incidence of DVT developing in patients who had been injured for more than 10 days. A routine examination to exclude DVT in these patients should be performed before arthroscopy.

LEVEL OF EVIDENCE: IV.