Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study
Abstract Background We sought to document the incidences of deep vein thrombosis (DVT) before and after total knee arthroplasty (TKA). In addition, we aimed to explor whether routine preoperative DVT evaluation was useful to establish DVT treatment strategies after TKA. Finally, we wanted to evaluat...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-018-2166-8 |
| _version_ | 1828402325686845440 |
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| author | Moon Jong Chang Min Kyu Song Min Gyu Kyung Jae Hoon Shin Chong Bum Chang Seung-Baik Kang |
| author_facet | Moon Jong Chang Min Kyu Song Min Gyu Kyung Jae Hoon Shin Chong Bum Chang Seung-Baik Kang |
| author_sort | Moon Jong Chang |
| collection | DOAJ |
| description | Abstract Background We sought to document the incidences of deep vein thrombosis (DVT) before and after total knee arthroplasty (TKA). In addition, we aimed to explor whether routine preoperative DVT evaluation was useful to establish DVT treatment strategies after TKA. Finally, we wanted to evaluate whether the incidences of DVT differed between patients undergoing unilateral and staged bilateral TKA within the same hospitalization period. Methods The retrospective study included 153 consecutive patients (253 knees) with osteoarthritis who underwent primary TKA. After surgery, mechanical compression devices (only) were used for DVT prophylaxis. DVT status before and after TKA was determined via 128-row, multidetector, computed tomography/indirect venography. Results Overall, the preoperative DVT incidence was 2.6% per patient and 1.6% per knee. All preoperative DVTs were distal in nature and asymptomatic. After TKA, newly developed thrombi were evident in various calf veins, without propagation of any pre-existing thrombi. Postoperatively, the overall incidences of DVT were 69.9% per patient and 58.5% per knee. The DVT incidences were 66% per patient and 69.8% per knee in the unilateral TKA group. In contrast, the incidences were 72% per patient and 55.5% per knee in the staged bilateral TKA group. There was one case of symptomatic distal (unilateral TKA; 0.65% per patient and 0.4% per knee) and proximal DVT (bilateral TKA; 0.65% per patient and 0.4% per knee), respectively. Conclusions The incidence of symptomatic DVT was low in Asian patients treated with mechanical compression devices alone, although substantial portion of patients had DVT after surgery. Routine preoperative DVT evaluation is probably not necessary; preoperative DVT was rare and of limited clinical relevance. Furthermore, staged bilateral TKA during a single period of hospitalization does not increase the incidence of DVT. |
| first_indexed | 2024-12-10T09:58:35Z |
| format | Article |
| id | doaj.art-2f95926baa6d457f9b447d0f9aff4f7c |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-10T09:58:35Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-2f95926baa6d457f9b447d0f9aff4f7c2022-12-22T01:53:25ZengBMCBMC Musculoskeletal Disorders1471-24742018-07-011911610.1186/s12891-018-2166-8Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography studyMoon Jong Chang0Min Kyu Song1Min Gyu Kyung2Jae Hoon Shin3Chong Bum Chang4Seung-Baik Kang5Department of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterDepartment of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterDepartment of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterDepartment of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterDepartment of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterDepartment of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical CenterAbstract Background We sought to document the incidences of deep vein thrombosis (DVT) before and after total knee arthroplasty (TKA). In addition, we aimed to explor whether routine preoperative DVT evaluation was useful to establish DVT treatment strategies after TKA. Finally, we wanted to evaluate whether the incidences of DVT differed between patients undergoing unilateral and staged bilateral TKA within the same hospitalization period. Methods The retrospective study included 153 consecutive patients (253 knees) with osteoarthritis who underwent primary TKA. After surgery, mechanical compression devices (only) were used for DVT prophylaxis. DVT status before and after TKA was determined via 128-row, multidetector, computed tomography/indirect venography. Results Overall, the preoperative DVT incidence was 2.6% per patient and 1.6% per knee. All preoperative DVTs were distal in nature and asymptomatic. After TKA, newly developed thrombi were evident in various calf veins, without propagation of any pre-existing thrombi. Postoperatively, the overall incidences of DVT were 69.9% per patient and 58.5% per knee. The DVT incidences were 66% per patient and 69.8% per knee in the unilateral TKA group. In contrast, the incidences were 72% per patient and 55.5% per knee in the staged bilateral TKA group. There was one case of symptomatic distal (unilateral TKA; 0.65% per patient and 0.4% per knee) and proximal DVT (bilateral TKA; 0.65% per patient and 0.4% per knee), respectively. Conclusions The incidence of symptomatic DVT was low in Asian patients treated with mechanical compression devices alone, although substantial portion of patients had DVT after surgery. Routine preoperative DVT evaluation is probably not necessary; preoperative DVT was rare and of limited clinical relevance. Furthermore, staged bilateral TKA during a single period of hospitalization does not increase the incidence of DVT.http://link.springer.com/article/10.1186/s12891-018-2166-8Venous thromboembolismDeep vein thrombosisTotal knee arthroplastyMechanical compression deviceIndirect venography |
| spellingShingle | Moon Jong Chang Min Kyu Song Min Gyu Kyung Jae Hoon Shin Chong Bum Chang Seung-Baik Kang Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study BMC Musculoskeletal Disorders Venous thromboembolism Deep vein thrombosis Total knee arthroplasty Mechanical compression device Indirect venography |
| title | Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study |
| title_full | Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study |
| title_fullStr | Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study |
| title_full_unstemmed | Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study |
| title_short | Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study |
| title_sort | incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis a 128 row multidetector ct indirect venography study |
| topic | Venous thromboembolism Deep vein thrombosis Total knee arthroplasty Mechanical compression device Indirect venography |
| url | http://link.springer.com/article/10.1186/s12891-018-2166-8 |
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