Risk factors for venous thromboembolism after knee arthroscopy: a systematic review and meta-analysis

膝关节镜术后静脉血栓栓塞的危险因素:系统评价和荟萃分析

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Abstract

BACKGROUND: Over the past few years, a growing number of knee arthroscopy (KA) procedures have been associated with an escalating incidence of postoperative venous thromboembolism (VTE), posing a significant threat to patient well-being. Nevertheless, the purpose of this study is to evaluate and synthesize the risk factors associated with VTE following KA, thereby establishing a scientific foundation for developing evidence-based clinical preventive measures. METHODS: We conducted a comprehensive search across the PubMed, Embase, Web of Science, and Cochrane Library databases for relevant literature spanning from January 1, 2019, to January 1, 2025. We meticulously reviewed all English-language observational studies about the risk factors associated with VTE after KA. The quality of the selected studies was critically appraised utilizing the Newcastle-Ottawa Scale (NOS). Subsequently, odds ratios (OR) and 95% confidence intervals (CI) were determined to assess the relationship between various risk factors and the incidence of VTE after KA. RESULTS: A total of 11 observational studies were included, all of which demonstrated moderate to high methodological quality. The studies involved 875,099 patients who underwent arthroscopic KA. The meta-analysis results indicated that the risk factors for venous thrombosis after KA include age over 30 years (OR = 1.59, 95% CI: [1.20, 2.12], P < 0.001), body mass index (BMI) over 25 (OR = 1.23, 95% CI: [1.07, 1.41], P = 0.004), and D-dimer over 0.62 mg/L (OR = 5.69, 95% CI: [1.41, 22.89], P = 0.014). CONCLUSION: Age over 30 years, BMI over 25, and D-dimer over 0.62 mg/L are significant risk factors for VTE following KA. Limited evidence also suggests an association between oral contraceptive use and a higher risk of VTE following KA.

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