Incidence and preventive treatment for deep vein thrombosis with our own preventive protocol in total hip and knee arthroplasty.

Takashige Momose, Masaki Nakano, Yukio Nakamura, Takashi Maeda, Masashi Nawata
Author Information
  1. Takashige Momose: Department of Orthopaedic Surgery, Marunouchi Hospital, Matsumoto, Nagano, Japan.
  2. Masaki Nakano: Department of Orthopaedic Surgery, Iida Hospital, Iida, Nagano, Japan.
  3. Yukio Nakamura: Department of Orthopaedic Surgery, Iida Hospital, Iida, Nagano, Japan. ORCID
  4. Takashi Maeda: Department of Orthopaedic Surgery, Marunouchi Hospital, Matsumoto, Nagano, Japan.
  5. Masashi Nawata: Department of Orthopaedic Surgery, Marunouchi Hospital, Matsumoto, Nagano, Japan.

Abstract

The aim of the present study was to investigate the perioperative and postoperative incidence of deep vein thrombosis (DVT) and validate the effectiveness of our own preventive treatment protocol for venous thromboembolism (VTE) occurrence in lower extremity arthroplasty patients. The subjects were 1,054 patients (mean age: 74.3 years) who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) at our institutions between April 2014 and March 2017. We examined the frequencies of pre- and post-operative DVT by lower extremity Doppler images, and the incidence rate at proximal or distal regions as well as that according to preoperative DVT status were evaluated. Preoperative DVT was detected in 6.5% (69 cases) of our cohort and those were located 1.4% (15 cases) at proximal and 5.1% (54 cases) at distal regions. A significantly higher rate of postoperative DVT development was observed in preoperative DVT+ THA patients (P = 0.0075), but not in TKA patients only with a higher tendency (P = 0.56). The overall incidence of DVT up to 2 weeks after surgeries was 27.3% (288 cases); however, the rate in proximal femur regions was suppressed to 2.8% (30 cases), and there was no symptomatic pulmonary thromboembolism (PTE) case. The results demonstrated the importance of regular Doppler examination for early detection of postoperative DVT occurrence and the following immediate treatment initiation. Our own VTE preventive treatment protocol could reduce the development of proximal DVT, and the periodic monitoring as well as prompt treatment might prevent the fatal PTE. osteoarthritis (OA), rheumatoid arthritis (RA).

References

  1. J Nucl Med. 1969 Jan;10(1):28-33 [PMID: 5797555]
  2. J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019848095 [PMID: 31084257]
  3. Clin Orthop Relat Res. 2019 Mar;477(3):523-532 [PMID: 30624321]
  4. J Orthop Surg Res. 2017 Apr 4;12(1):55 [PMID: 28376907]
  5. Chest. 2004 Sep;126(3 Suppl):338S-400S [PMID: 15383478]
  6. J Orthop Surg Res. 2021 Jan 25;16(1):82 [PMID: 33494760]
  7. Bone Joint J. 2016 Aug;98-B(8):1056-61 [PMID: 27482017]
  8. J Korean Med Sci. 2010 Jan;25(1):28-34 [PMID: 20052344]
  9. J Bone Joint Surg Br. 2005 Aug;87(8):1117-22 [PMID: 16049250]
  10. Knee Surg Relat Res. 2020 Sep 22;32(1):49 [PMID: 32962751]
  11. J Arthroplasty. 2020 Jan;35(1):259-264 [PMID: 31530463]
  12. Ann Biol Clin (Paris). 1990;48(4):235-8 [PMID: 2193559]
  13. Arch Intern Med. 2000 Dec 11-25;160(22):3415-20 [PMID: 11112234]
  14. J Orthop Surg Res. 2015 Nov 10;10:172 [PMID: 26555394]
  15. J Thromb Haemost. 2005 Jan;3(1):28-34 [PMID: 15634263]
  16. Am J Health Syst Pharm. 2010 Sep 1;67(17):1438-45 [PMID: 20720243]
  17. J Orthop Surg Res. 2014 Oct 10;9:89 [PMID: 25304935]
  18. J Bras Pneumol. 2013 May-Jun;39(3):280-6 [PMID: 23857692]

MeSH Term

Humans
Aged
Arthroplasty, Replacement, Knee
Venous Thromboembolism
Incidence
Venous Thrombosis
Arthritis, Rheumatoid
Pulmonary Embolism
Postoperative Complications
Arthroplasty, Replacement, Hip
Risk Factors

Word Cloud

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