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

Study Design: Case Report.

Background: 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.

Case Description: The purpose of this report is to present the case of 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 (8 days post-operatively), which raised the index of suspicion for an UEDVT.

Outcome: 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.

Discussion: UEDVT events following arthroscopy are rare, and 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 manifestation, best treatment, and future research.