Rates of Deep Vein Thrombosis Occurring After Osteotomy About the Knee

Abstract

We conducted a study to determine the rates of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) after high tibial osteotomy (HTO), distal femoral osteotomy (DFO), or tibial tubercle osteotomy (TTO) in patients who did not receive postoperative chemical prophylaxis. All patients who had HTO, DFO, or TTO performed by a single surgeon between 2009 and 2014 were identified. Charts were reviewed to determine presence or absence of DVT or PE. Patient age, smoking status, oral contraceptive (OC) use, and body mass index (BMI) were recorded. Patients received no chemical or mechanical prophylaxis after surgery. We identified 141 patients (44% male, 56% female) who underwent HTO, DFO, or TTO. Mean (SD) age was 34.28 (9.86) years, mean (SD) follow-up was 17.1 (4.1) months, and mean (SD) BMI was 26.88 (5.11) kg/m2. Overall, 36.7% of female patients used OCs, and 13.48% of all patients were smokers. After surgery, 2 patients (1.42%) developed below-knee DVT (unilateral in 1 case, bilateral in the other). The bilateral DVT case progressed to PE. Neither patient smoked, but the bilateral DVT/PE patient was using OCs. DVT patients' mean (SD) age was 48.16 (8.24) years, and their mean (SD) BMI was 23.18 (0.18) kg/m2. HTO, DFO, and TTO patients who did not receive chemical prophylaxis had low rates of DVT (1.42%) and PE (0.71%). Administration of DVT/PE prophylaxis after these osteotomies may not be warranted.