A patient comes in OPD for treatment of partial meniscectomy after 2 weeks and complains about pain in calf muscle. The signs include pain, inflammation and swelling in calf. My question: Can DVT happen after 2 weeks or is there any other reason for that?

A partial meniscectomy refers to the surgical removal of part of either the lateral or medial meniscus of the knee joint(s). Increasingly, in well-selected patients, arthroscopic partial meniscectomy is the surgical method of choice for treatment of meniscal injuries when repair techniques are not a viable option because it is a minimally invasive procedure which has the advantage of low morbidity, fast rehabilitation and low cost of care.

Yes, DVT can occur as a sequel to partial meniscectomy especially if the patient has a previous history of Thromboembolic Disease (TED). In a 2013  study; Complications of arthroscopic meniscectomy in the hands of third world beginners by Muzzafar and Shah, the researchers indicated that although the risk of TED after arthroscopy is low (since the arthroscopic procedure is relatively short and mobilization is quick) it is still a risk nonetheless.

The researchers also referenced other studies which showed the incidence of TED to be 0.1%, 0.17% and 0.13%, respectively. The overall reported incidence of DVT after arthroscopy of the knee ranges from 0% to 7.3% and Pulmonary Embolism (PE) from 0% to 0.32%. In a study using venography, the incidence of DVT was 4.2%. The figures for DVT were probably underestimated, since the reviews were based on clinical symptoms.

There are a number of factors which are associated with an increased risk of thromboembolism. Patients over the age of 40 years are more likely to develop postoperative thrombosis. A prolonged operating or tourniquet time is also a risk factor (but there is no definite evidence that the tourniquet itself increases the risk). When there is a previous history of thrombosis or embolism, the risk of thromboembolic complications increases significantly. A separate referenced study reported an incidence of DVT of 100% in a group of patients with a history of previous PE.

Finally, current best practices discourage the use of clinical tests alone (such as Homan’s test) to diagnose DVT. A Doppler ultrasonography test is usually a safer and faster option.

You can review the research work here.

Reference 1