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Case Report

Upper extremity deep venous thromboembolism following arthroscopic labral repair of the shoulder and biceps tenodesis: a case report.

Authors: Durant TJS, Swanson BT, Cote MP, Allen DA, Arciero RA, Mazzocca AD

Upper extremity deep vein thrombosis (UEDVT) is a rare complication following arthroscopic shoulder surgery. However, it is possible that a patient with an UEDVT will present to physical therapy as the first service to interact with the patient following surgery. As a result, proper screening in the physical therapy setting is essential. The purpose of this case report is to describe the course of diagnosis for a 37 year-old male who developed an upper extremity deep vein thrombosis (UEDVT) following arthroscopic glenohumeral labral repair and arthroscopically-assisted biceps tenodesis. This patient presented with disproportionate pain and swelling of his involved upper extremity at his initial evaluation in physical therapy (eight days post-operatively), which raised the index of suspicion for an UEDVT. The patient was referred to the emergency department for immediate diagnostic testing and treatment. A Doppler scan provided a definitive diagnosis of UEDVT. Following successful medical treatment with anti-coagulant therapy, the patient went on to complete an otherwise uneventful course of rehabilitation. While UEDVT events following arthroscopy are rare, they are often attributed to a systemic secondary stimulus. UEDVT following shoulder arthroscopy is a complication that occurs in the orthopaedic setting, but may present primarily to the physical therapist, and as such requires awareness of its clinical presentation and treatment. Care of UEDVT requires a systems-based approach when considering clinical presentation and manifestation, best treatment, and future research.

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