A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty

Abstract

Deep vein thrombosis is one of the main complications of total knee arthroplasty. Hematoma is another complication often seen following total knee arthroplasty, but a search of the literature found no reports of deep vein thrombosis caused by hematoma. A case of a 68-year-old woman with knee osteoarthritis who underwent total knee arthroplasty, with subsequent onset of thrombosis caused by hematoma, is reported. The surgery was performed through the medial parapatellar approach with measured resection and the implant was put in place with cement fixation. On postoperative day 7, there was still leakage of exudate from the wound, and swelling of the lower leg appeared. Therefore, infection or thrombosis was suspected, and contrast-enhanced computed tomography was performed. Accumulation of fluid was found from the thigh to the knee, and when paracentesis was carried out, blood was drawn, resulting in a diagnosis of hematoma. In addition, the blood vessels were under pressure from the hematoma, and thrombosis was diagnosed based on the clinical, blood analysis, and ultrasound findings. There was concern about treatment due to coexistence of hematoma and thrombi, but through application of a Robert Jones bandage and administration of edoxaban, the patient made good progress with no major complications. A case of deep vein thrombosis caused by hematoma following total knee arthroplasty was reported. The patient recovered without major complications through administration of edoxaban and application of a Robert Jones bandage.