Abstract
Background: The relationship of preoperative D-dimer and Venous thromboembolism (VTE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early VTE after TKA and THA. Materials and Methods: A total of 312 patients were evaluated in this retrospective study from 2016 to 2020 at a tertiary care centre, Mumbai who were operated for THA and TKA. The measurement of plasma D-dimer level was done preoperatively and clinically symptomatic patients were evaluated and confirmed for VTE by Colour Doppler Sonography. The plasma D-dimer levels were correlated statistically with the sonographic VTE. Results: 11 patients developed Deep Vein Thrombosis (DVT) and 1 patient developed Pulmonary embolism (PE). Preoperative plasma D-dimer levels were significantly higher (P (pelvic and femoral veins), and 2 thrombi were seen in distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in THA patients, and all 8 thrombi were seen in the distal veins (posterior tibial, peroneal, gastrocnemian veins) of the calf in TKA patients. Conclusion: We infer that if the preoperative D-dimer levels were more than 0.5 mg/l, the chances of developing VTE postoperatively are more, which can be diagnosed clinically and further by other investigations. In this study, we have shown that doing preoperative D-dimer level can almost PREDICT the development of VTE and thus prevent complications.
Highlights
Anticipating medical disasters and reducing medical challenges has been considered in the realms of Astrologers and Soothsayers
Colour Doppler Sonography showed that 2 thrombi were seen in proximal veins, and 2 thrombi were seen in distal veins of the calf in total hip arthroplasty (THA) patients, and all 8 thrombi were seen in the distal veins of the calf in total knee arthroplasty (TKA) patients
There was no statistically significant association seen with the occurrence of Deep Vein Thrombosis (DVT) with the type of surgery (THA, TKA), we have seen that DVT was more common in the THA group (Table 3)
Summary
Venous thromboembolism (VTE) is a complex vascular disease that commonly manifests as deep vein thrombosis (DVT) and pulmonary embolism (PE) [1]. The relationship of preoperative D-dimer and Venous thromboembolism (VTE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The measurement of plasma D-dimer level was done preoperatively and clinically symptomatic patients were evaluated and confirmed for VTE by Colour Doppler Sonography. Preoperative plasma D-dimer levels were significantly higher (P < 0.01) in patients who developed DVT postoperatively. Conclusion: We infer that if the preoperative D-dimer levels were more than 0.5 mg/l, the chances of developing VTE postoperatively are more, which can be diagnosed clinically and further by other investigations. We have shown that doing preoperative D-dimer level can almost PREDICT the development of VTE and prevent complications
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