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Mechanical thromboprophylaxis would suffice after total knee arthroplasties in Asian patients?

  • Young-Hoo Kim
  • V. Anil
  • Ashwini Gaurav
  • Jang-Won Park
  • Jun-Shik Kim
Orthopaedic Surgery
  • 58 Downloads

Abstract

Purpose

Our prospective study evaluated the incidence and location of deep vein thrombosis (DVT), the risk factors for PE and the natural history of DVT after TKA in patients who have received only mechanical compression device without having any chemical thromboprophylaxis or therapeutic treatment.

Methods

We studied 408 consecutive patients (691 knees) who underwent primary TKA; 283 patients had one-stage bilateral TKAs and 125 had unilateral TKAs. Coagulation assays, the full blood count and blood typing tests, and serum chemical profiles were undertaken in all patients on three separate occasions. Molecular genetic testing was performed preoperatively to detect the genetic traits involving DVT. Bilateral simultaneous or unilateral venograms were carried out at 6 or 7 days after operation. Perfusion lung scanning was undertaken before and at 7 or 8 days after operation.

Results

In the 691 venograms in 408 patients, only 4 knees (0.6%) were positive for fresh thrombi. In the 4 knees with DVT, thrombi were located in the calf veins. We observed factor V Leiden mutation, antithrombin-III level, and prothrombin promoter G20210A mutation were absent in all patients. We saw no relationship between DVT and coagulation or thrombophilic data. No pulmonary embolism (PE) occurred as shown by negative perfusion lung scan and absence of symptoms.

Conclusion

We concluded that the combinations of absent thrombophilic polymorphisms with low clinical prothrombotic risk factors led to low prevalence of DVT and virtually absent PE after TKA in the current series of patients, who had received mechanical compression device only without chemical thromboprophylaxis.

Keywords

Prevalence deep vein thrombosis Pulmonary embolism Total knee arthroplasty Chemical thromboprophylaxis Mechanical compression device 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article contains studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Young-Hoo Kim
    • 1
  • V. Anil
    • 1
  • Ashwini Gaurav
    • 1
  • Jang-Won Park
    • 2
  • Jun-Shik Kim
    • 2
  1. 1.The Joint Replacement CenterSeoul Metropolitan SeoNam HospitalSeoulRepublic of Korea
  2. 2.The Joint Replacement CenterEwha Womans University MokDong HospitalSeoulRepublic of Korea

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