Risk Factors for Venous Thromboembolism (VTE) Following Anterior Cruciate Ligament (ACL) reconstruction: A systematic review and meta-analysis

IF 2.2 3区医学 Q2 ORTHOPEDICS

Orthopaedics & Traumatology-Surgery & Research Pub Date : 2025-10-01 DOI:10.1016/j.otsr.2025.104184

Yao-Tung Tsai, Chia-Chun Wu, Ru-Yu Pan, Pei-Hung Shen

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引用次数: 0

Abstract

Background

Thromboembolism (VTE) is an uncommon, but potentially serious complication in patients who undergo anterior cruciate ligament (ACL) reconstruction.

Patients and methods

PubMed, EMBASE, and Cochrane databases were searched for relevant studies published until July 16, 2023. Eligible studies were those investigating patients who were undergoing ACL reconstruction, with the primary focus on factors associated with VTE including age, sex, body mass index (BMI), hypertension, smoking, type of surgical setting (outpatient vs. inpatient), and tourniquet time.

Results

Six studies consisted of a total of 47,886 patients underwent ACL reconstruction were included. The VTE rate ranged between 0.4% and 11.0%, and the mean patient age ranged from 26.8 to 33.25 years. The meta-analysis revealed no significant association between VTE risk and sex (pooled adjusted odds ratio [aOR] = 1.28, 95% confidence interval [CI]: 0.88–1.85). Furthermore, the meta-analysis showed a significantly higher risk of VTE in smokers compared to non-smokers, favoring non-smokers (pooled aOR = 1.71, 95% CI: 1.16–2.54). The systematic review identified several other potential factors, including older age, BMI, hypertension, smoking, surgical setting, and tourniquet time, which were documented in at least 2 included studies. However, while some of these factors showed reported significance, the number of studies was insufficient to generate a pooled result.

Discussion

According to our meta-analysis, sex does not appear to be a significant risk factor for VTE in patients undergoing ACL reconstruction. However, more evidence is needed to determine whether factors such as older age, BMI, hypertension, outpatient vs. inpatient surgery, and tourniquet time are associated with increased VTE risk. Caution is still advised when managing patients with these risk factors in the context of ACL reconstruction. A future meta-analysis is warranted once a sufficient number of studies are available to draw more definitive conclusions.

Level of evidence

查看原文本刊更多论文

前交叉韧带（ACL）重建后静脉血栓栓塞（VTE）的危险因素：系统回顾和荟萃分析。

背景：在前交叉韧带（ACL）重建患者中，血栓栓塞（VTE）是一种罕见但潜在的严重并发症。患者和方法：检索PubMed、EMBASE和Cochrane数据库，检索截至2023年7月16日发表的相关研究。符合条件的研究是那些接受ACL重建的患者，主要关注与静脉血栓栓塞相关的因素，包括年龄、性别、体重指数（BMI）、高血压、吸烟、手术环境类型（门诊与住院）和止血带时间。结果：6项研究共纳入47886例ACL重建患者。静脉血栓栓塞率为0.4% ~ 11.0%，患者平均年龄为26.8 ~ 33.25岁。荟萃分析显示静脉血栓栓塞风险与性别之间无显著关联（合并校正优势比[aOR] = 1.28, 95%可信区间[CI]: 0.88-1.85）。此外，荟萃分析显示，吸烟者患静脉血栓栓塞的风险明显高于非吸烟者，这有利于非吸烟者（综合aOR = 1.71, 95% CI: 1.16-2.54）。系统评价确定了其他几个潜在因素，包括年龄较大、BMI、高血压、吸烟、手术环境和止血带时间，这些因素在至少2项纳入的研究中得到了记录。然而，虽然其中一些因素显示出报道的重要性，但研究的数量不足以产生汇总结果。讨论：根据我们的荟萃分析，性别似乎不是前交叉韧带重建患者静脉血栓栓塞的重要危险因素。然而，需要更多的证据来确定年龄、BMI、高血压、门诊与住院手术、止血带时间等因素是否与静脉血栓栓塞风险增加有关。在ACL重建的背景下，仍然建议在管理具有这些危险因素的患者时要谨慎。一旦有足够数量的研究得出更明确的结论，未来的荟萃分析是有必要的。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedics & Traumatology-Surgery & Research 医学-外科

CiteScore

5.10

自引率

26.10%

发文量

329

审稿时长

12.5 weeks

期刊介绍： Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.