Abstract
Objective: Deep vein thrombosis (DVT) after total knee arthroplasty (TKA) is very common and leading cause of death due to this procedure. The objective of this study was to investigate the incidence and clinical characteristics of DVT after TKA with DVT chemoprophylaxis. Methods: This is a prospective cohort study in single institution. The patients received postoperative DVT chemoprophylaxis (low molecular weight heparin (LMWH) or Fondaparinux), followed by duplex ultrasonography to check for DVT 1 - 2 weeks after TKA. The clinical characteristics were summarized and analysed by chi-square test and regression analysis. Results: Five hundred and thirty four patients were enrolled from January 2007 to December 2010. DVT chemoprophylaxis was administered in 524 (98.1%) of the 534 patients. DVT occurred in 9 subjects (1.69%); 8 subjects had DVT in the leg, and 1 subject had a pulmonary embolism. Among them, asymptomatic DVT was observed in 5 patients (0.94%). Univariate analysis showed that surgical methods (revision, P = 0.0007), body mass index (BMI) (>25, P = 0.0028), low platelet count (less than 150 × 103, P = 0.0219), time in the intensive care unit (ICU) (P < 0.0001), no administration of prophylactic LMWH (P = 0.0392), and a history of DVT (P < 0.0001) were significant risk factors of DVT. Conclusions: The incidence of DVT was 1.69% after TKA with prophylactic antithrombotic therapy. Revision surgery, BMI, low platelet count, time in ICU, absence of prophylactic LMWH and history of DVT were significant risk factors of DVT.
Highlights
In the United States and Europe, venous thromboembolism has gained attention due to the associated morbidity, mortality, and increased treatment costs
The true incidence of venous thromboembolism in patients with injuries such as hip fractures is under dispute, deep vein thrombosis (DVT) prophylaxis is still suggested [1]-[7]
Recent studies performed in Asia reported that the observed incidences of venous thromboembolism were 50%, 9.8% - 64.3%, and 11.3% - 76.5% for pelvic fractures, THA, and total knee arthroplasty (TKA), respectively, when DVT prophylaxis was not administered
Summary
In the United States and Europe, venous thromboembolism has gained attention due to the associated morbidity, mortality, and increased treatment costs. Recent studies performed in Asia reported that the observed incidences of venous thromboembolism were 50%, 9.8% - 64.3%, and 11.3% - 76.5% for pelvic fractures, THA, and TKA, respectively, when DVT prophylaxis was not administered. These results are similar to other studies performed in the United States and Europe [8]-[18]. A high incidence of venous thromboembolism, especially in TKA cases (40.4%), was observed after major orthopedic surgery in a recent study [20] with 363 Korean patients. We aimed to identify the incidence and clinical characteristics of DVT after total knee arthroplasty with DVT chemoprophylaxis
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