• Yun Guan and Zhimin Zeng.
• Medical center, Ningbo NO. 6 Hospital, Ningbo, Zhejiang, China.
• Medicine (Baltimore). 2021 Jan 8; 100 (1): e24230e24230.

IntroductionAlthough venous thromboembolism (VTE) is relatively rare after unicompartmental knee arthroplasty (UKA), symptomatic pulmonary embolism (PE) can be fatal. Whether routine thromboprophylaxis or thrombolytic treatment is necessary for patients undergoing UKA remains unclear. Here, we present a case of delayed pulmonary embolism after UKA.Patient ConcernsA 57-year-old women underwent cemented UKA for left localized medial knee pain. There were no risk factors of VTE besides high BMI before surgery. 2 months after surgery, the patient presented with dyspnea and palpitation, and these symptoms could not be alleviated after rest.DiagnosisAn arterial blood gas analysis showed decreased PO2, SO2 and PCO2. Pulmonary CTA showed multiple pulmonary embolism in the trunk of the right lower pulmonary artery and the branch of the left lower pulmonary arteries. The final diagnosis was delayed pulmonary embolism after UKA.InterventionsUrokinase thrombolysis was administered intravenously. Low molecular weight heparin and warfarin were prescribed for anticoagulation.OutcomesThe patient's symptoms abated, and chest CTA showed that the pulmonary embolism had dissolved. No further thrombosis has been observed for more than 6 years.ConclusionsWe presented an unusual case of delayed pulmonary embolism after UKA. Despite the low incidence, its life-threatening nature makes it imperative for surgeons to be well-informed about thrombosis and pay more attention to its prevention strategies.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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