Abstract
BackgroundHemorheological parameters have been confirmed to be related with deep vein thrombosis (DVT). This study is aimed to verify whether preoperative erythrocyte electrophoresis exponent was associated with postoperative deep vein thrombosis (DVT) risk after total knee arthroplasty (TKA) in patients with primary knee osteoarthritis (KOA).MethodsFrom March 2010 to May 2020, a total of 750 consecutive KOA patients who accepted unilateral TKA were enrolled. They were divided into DVT (176 patients) and non-DVT groups (574 patients) according to the examination results of the Doppler ultrasound of deep veins in both lower limbs on postoperative day 3. The Chi-square test, Student’s t test, and multivariate logistic regression analysis were performed to analyze the correlation of erythrocyte electrophoresis exponent and DVT risk in 2 groups. Receiver operating characteristic (ROC) analysis was used to assess predictive value of erythrocyte electrophoresis exponent for DVT.ResultsA low erythrocyte electrophoresis exponent was a significant risk factor for DVT in patients with primary KOA (p < 0.05), especially in females when stratified by gender (p < 0.05).ConclusionsThe findings suggest that lower erythrocyte electrophoresis before surgery may be independently associated with a higher post-surgery DVT risk in primary KOA patients. It is necessary to optimize prophylaxis strategies for DVT in these patients.
Highlights
Osteoarthritis (OA) is the most prevalent form of degenerative arthritis and a major cause of pain and disability that preferentially affected the middle-aged and elderly people in global [1, 2]
Clinical information including the potential risk factors and medical histories were collected according to their selfreport, which mainly consisted of age, gender, diabetes, hypertension, malignancy, cardiovascular events, Venous thromboembolism (VTE) events, steroids or estrogen use, smoking, surgery history, and blood transfusion history
In the multivariate analysis (Table 3), it could be found that a low erythrocyte electrophoresis exponent was a significant risk factor for postoperative deep vein thrombosis (DVT) in both all the patients (OR = 0.606, 95% Confidence interval (CI) = 0.436–0.841, p = 0.003) and female patients (OR = 0.568, 95% CI = 0.399–0.810, p = 0.002) after stratified by gender with adjustment for age, body mass index (BMI), serum lipids, coagulation indexes, and all the other confounding factors in this study
Summary
Osteoarthritis (OA) is the most prevalent form of degenerative arthritis and a major cause of pain and disability that preferentially affected the middle-aged and elderly people in global [1, 2]. Venous thromboembolism (VTE), which comprises DVT and pulmonary embolism PE, is a major and potentially fatal complication following TKA [4]. DVT incidence after TKA ranged from about 18.1 to 48.6% without thromboprophylaxis in Asian patients [4]. The available guidelines [5] recommended that KOA patients should undergo routine thrombosis prevention after TKA, adverse complications of bleeding and deep inflammation cannot be ignored [4, 6]. Hemorheological parameters have been confirmed to be related with deep vein thrombosis (DVT). This study is aimed to verify whether preoperative erythrocyte electrophoresis exponent was associated with postoperative deep vein thrombosis (DVT) risk after total knee arthroplasty (TKA) in patients with primary knee osteoarthritis (KOA)
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