Deep vein thrombosis after total knee arthroplasty

Background and purpose: The incidence of deep vein thrombosis (DVT) after t otal knee arthroplasty (TKA) in the Asian population is probably higher tha n is commonly assumed bu clinicians. The purpose of this study was to inves tigate the incidence of DVT after TKA in a southern Taiwanese population an d to determine whether routine prophylaxis against DVT is indicated. Materials and methods: The incidence of DVT was investigated in 107 ascendi ng venograms performed in 105 knees in 102 patients after TKA. Observations were made and interpreted by orthopedic radiologists blinded to the clinic al condition of the patients. The correlation of DVT with the medical condi tions, anesthesia type, and local physical findings were analyzed. Results: The overall incidence of DVT after TKA was 63.6% (68/107); 95.6% ( 63/68) of cases involved the distal veins in the calf and only 4.4% (3/68) involved the proximal vein at the popliteal level. There was no higher inci dence of thrombosis in die femoral and iliac reins, and no pulmonary emboli sm. Approximately 70% of patients with DVT were symptomatic and required tr eatment. There was no statistically significant correlation of DVT with med ical condition, including diabetes mellitus. hypertension. body weight, var icosity, history of thromboembolic disorder and congestive heart failure, o r the type of anesthesia or bone cement used. There was a positive correlat ion of DVT with local physical findings including calf girth enlargement, l et: edema, and skits discoloration, and a negative correlation with finding s including Homans' sign, cord induration, venous engorgement, and knee eff usion. Conclusion: The incidence of DVT after TKA in this southern Taiwanese cohor t was similar to tf,at in Western populations, and higher than is commonly assumed by clinicians at this facility. However, the rate of proximal throm bosis and pulmonary embolism was much lower than in previous studies from W estern populations. The majority of cases of DVT involved the veins in the calf: approximately 70% of patients were symptomatic and required treatment .