Editorial Commentary: Should the Virchow Triad Have Been a Quartet? Is High Altitude a Risk Factor for Deep Venous Thrombosis After Knee Arthroscopy?

Abstract

The Virchow triad includes stasis of blood flow, endothelial injury, and hypercoagulability. It forms the physiological foundation for the development of one of our most dreaded complications: deep venous thrombosis. Although the complication rate after knee arthroscopy remains low, significant morbidity may be associated with thromboembolic events. Tyson et al. report an increased incidence of venous thromboembolism in knee operations performed at higher altitudes versus those conducted closer to sea level. Multiple acquired conditions and inherited traits have been identified as risk factors for the development of venous thromboembolism. Geographic altitude should be included within this list.