S Thromboembolism events following anterior cruciate ligament reconstruction: Is chemical prophylaxis really not needed? (0114) Saithna A ([email protected]), Jordan RW, Gee E. Southport and Ormskirk Hospitals. Current BASK guidelines state that routine chemical thromboprophylaxis is not required for ACL reconstruction. Recent literature suggests that the rate of VTE is higher than previous reports upon which existing guidelines are based. In addition it is not known to what extent these guidelines are followed and some surgeons do use chemical prophylaxis A systematic review was conducted (protocol registered with PROSPERO). Studies were included if they represented original research and the main focus of the article was to report VTE rates in patients undergoing ACL reconstruction. Critical appraisal was performed using the GRADE tool Results: • 8 studies were included, apart from 1 RCT all others scored GRADE 2C indicating significant weaknesses including a lack of a control group • Incidence of asymptomatic DVT: Thromboprophylaxis group (2.9%), No prophylaxis group (9.7%) • Rate of symptomatic DVT not explicitly stated by all authors (but reported as 4% in two cohorts with no prophylaxis) • No bleeding complications reported with prophylaxis Conclusions: • Current evidence has significant limitations which prevent a clear understanding of the rate of symptomatic VTE with and without chemical prophylaxis – this is essential information to answer the research question posed • However, the rate of 4% DVT (with no prophylaxis) is higher than previous reports on which existing guidelines are based • Asymptomatic DVT appears to occur frequently. The rate is often dismissed as unimportant but it can lead to post thrombotic syndrome and should be considered

BASK 2016 Poster: DVT Prophylaxis for Patients Undergoing Anterior Cruciate Ligament Reconstruction

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Page 1: BASK 2016 Poster: DVT Prophylaxis for Patients Undergoing Anterior Cruciate Ligament Reconstruction

Thromboembolism events following anterior cruciate ligament reconstruction: Is chemical prophylaxis really not needed? (0114)

Saithna A ([email protected]), Jordan RW, Gee E. Southport and Ormskirk Hospitals.

Current BASK guidelines state that routine chemical thromboprophylaxis is not required for ACL reconstruction. Recent literature suggests that the rate of VTE is higher than previous reports upon which existing guidelines are based. In addition it is not known to what extent these guidelines are followed and some surgeons do use chemical prophylaxis

A systematic review was conducted (protocol registered with PROSPERO). Studies were included if they represented original research and the main focus of the article was to report VTE rates in patients undergoing ACL reconstruction. Critical appraisal was performed using the GRADE tool

Results:• 8 studies were included, apart from 1 RCT all others scored GRADE

2C indicating significant weaknesses including a lack of a control group

• Incidence of asymptomatic DVT: Thromboprophylaxis group (2.9%), No prophylaxis group (9.7%)

• Rate of symptomatic DVT not explicitly stated by all authors (but reported as 4% in two cohorts with no prophylaxis)

• No bleeding complications reported with prophylaxis

Conclusions: • Current evidence has significant limitations which prevent a clear

understanding of the rate of symptomatic VTE with and without chemical prophylaxis – this is essential information to answer the research question posed

• However, the rate of 4% DVT (with no prophylaxis) is higher than previous reports on which existing guidelines are based

• Asymptomatic DVT appears to occur frequently. The rate is often dismissed as unimportant but it can lead to post thrombotic syndrome and should be considered

• There is insufficient evidence of high quality to provide a robust scientific basis for clinical guidelines. However, it should be noted that the only RCT that specifically evaluates this issue supports the use of chemical prophylaxis and is in accordance with other studies. This suggests that further study is required