Thromboembolic complication after arthroscopic shoulder surgery.

Thromboembolic complications after arthroscopic shoulder surgery are very unusual and need thorough investigation of the possible origin. In this case of venous pulmonary thromboembolism after arthroscopy of the shoulder, neither a hint of coagulopathy nor an anatomic abnormality could be found that explains this complication. Therefore, irritation of the subclavian vein caused by compression by the motor-driven shaver is probably one cause for our thromboembolic complication. Careful attention to positioning, fluid management, and use of traction, as well as an appreciation of shoulder anatomy to select portal placement will help decrease the common complications associated with shoulder arthroscopy. A further option to prevent thrombembolic complications in shoulder arthroscopy patients might be prophylaxis with a low-weight heparin in patients with risk factors. In conclusion, awareness of uncommon complications such as deep venous thrombosis and pulmonary embolism will help the orthpaedic surgeon promptly diagnose and treat these problems.