Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Randomized Controlled Trial Clinical Trial
Prevention of venous thromboembolism after knee arthroscopy with low-molecular weight heparin (reviparin): Results of a randomized controlled trial.
Deep venous thrombosis (DVT) is a common, important complication of major orthopaedic surgery, particularly knee arthroplasty. Knee arthroscopy is increasingly performed on an outpatient basis. Few reports have elucidated the incidence of venous thromboembolism (VTE) in patients undergoing arthroscopic surgery receiving no prophylaxis. The objective of the present trial was to evaluate the risk of VTE in those patients and to determine efficacy and safety of a low-molecular weight heparin (LMWH) in preventing VTE. ⋯ Patients undergoing knee arthroscopy have a moderate risk of VTE and effective prophylaxis can be achieved with LMWH (reviparin).
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Complications have been described with each technique for reconstruction of the anterior cruciate ligament (ACL) in the knee, both open and arthroscopically assisted. The authors describe a case of tibial plateau fracture occurring 7 months after an ACL reconstruction using the half tunnel technique. ⋯ To our knowledge, only 2 cases of proximal tibial fracture after patellar tendon autograft ACL reconstruction have been previously reported. The authors hypothesize that patellar tendon harvesting with bone blocks and transosseous tibial tunnel can produce a "stress riser" effect and somehow act synergistically to create decreased strength at the level of proximal tibial metaphysis.