Incidence of Symptomatic Thromboembolic Disease After Patellofemoral Arthroplasty
Ashley Levack, MAS, Atul F. Kamath, MD, and Jess H. Lonner, MD
Ms. Levack is Medical Student, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Dr. Kamath is Clinical Instructor, Department of Orthopaedic
Surgery, Hospital of the University of Pennsylvania, Philadelphia,
Pennsylvania.
Dr. Lonner is Attending Orthopaedic Surgeon, Rothman Institute;
and! Associate Professor, Department of Orthopaedic Surgery
Thomas Jefferson University, Philadelphia, Pennsylvania.
Venous thromboembolic (VTE) disease is a risk after patellofemoral arthroplasty (PFA) despite its less invasive nature and faster recovery. To our knowledge, this is the first study to address the incidence of VTE disease after PFA. One hundred forty-nine consecutive primary or revision PFA procedures were followed for the primary endpoint of symptomatic VTE/pulmonary embolus within 6 weeks after surgery. VTE prophylaxis type, American Society of Anesthesiologists (ASA) class, VTE risk factors, and complications were noted. The mean age of the patient population was 48 years. Eighty-three percent of patients received aspirin and calf pumps; 17% received warfarin. The average operative time was 76 minutes overall and 66 minutes for isolated PFA. One patient with an undisclosed family history of VTE, who was managed with aspirin and calf pumps, developed multiple small pulmonary emboli. No other VTE complications occurred. Symptomatic VTE incidence was 0.76%. Patients without significant risk of thrombosis undergoing PFA may be effectively managed with an aspirin-based protocol.