Summary

The purpose of this study is to investigated Japanese deep vein thrombosis: DVT and pulmonary embolism: PE after total knee arthroplasty.

Abstract

Purpose

The purpose of this study is to investigated Japanese deep vein thrombosis: DVT and pulmonary embolism: PE after total knee arthroplasty.
[Cases and methods]
304 were assessed deep vein thrombosis and pulmonary embolism after total knee arthroplasty using enhanced CT at one day and fourteen days postoperatively. Mean age was 75±9(53-92) years old, side was 166 right and 142 left, bilateral side TKA was 90 and one side TKA was 128. All cases were checked preoperative DVT using ultrasound ECHO, two patients having DVT were treated using heparin drip infusion preoperatively. BMI ?s26.1±7.9(19.6-38). Operative time was 113.1±28.3 (71-180)minuets. 300 primary and 4 revisions.

Results

1. One side TKA.
1) DVT. postoperative one day. 59/128 (46%) was no DVT and 69/128(54%) had DVT: posterior tibial vein 46/128 (35.9%), peroneal vein16/128 (12.5%), soleus vein 7/128 (5.6%). Postoperative fourteen days. 72/128 (56.3%) was no DVT and 56/128 (43.7%) had DVT: posterior tibial vein 26/128 (20.3%), peroneal vein20/128 (15.6%), soleus vein 10/128 (3.8%).
2) PE. postoperative one day. 121/128 (94.5%) was no PE and 7/128 (5.5%) had PE: right pulmonary artery A4-5 7/128 only. Postoperative fourteen days. 118/128 (92.3%) was no PE and 10/128 (7.7%) had PE: right pulmonary artery 4-57/128 (5.1%), right pulmonary artery A3 3/128(2.6%).
2. Bilateral side TKA
1) DVT. postoperative one day. 66/90 (73.3%) was no DVT and 24/90 (26.7%) had DVT: posterior tibial vein 10/90 (11.8%), peroneal vein10/90 (11.8%), soleus vein 0/90 (0%), posterior tibial vein and peroneal vein 1/90 (2.9%). Postoperative fourteen days. 72/128 (56.3%) was no DVT and 56/128 (43.7%) had DVT: posterior tibial vein 19/90 (20.3%), peroneal vein 13/90 (14.7%), soleus vein 3/90 (3.8%), posterior tibial vein and peroneal vein 5/90 (5.8%), peroneal vein and soleus vein 3/90 (2.9%).
2) PE. postoperative one day. 80/90 (88.2%) was no PE and 10/90 (11.8%) had PE: right pulmonary artery A8 5/128 (5.9%), right pulmonary artery A5 and left pulmonary artery A10. Postoperative fourteen days. 74/90 (82.4%) was no PE and 16/128 (17.6%) had PE: right pulmonary artery A4-5 9/90 (10%), right pulmonary artery A8 3/90 (3.8%), left pulmonary artery A10 3/90(3.8%).
[Consideration and summary]
Cause of low DVT frequency postoperative1 day after bilateral TKA was unknown, but, almost 50% postoperative 1, 14 days after one side TKA, postoperative 14 days after bilateral TKA. PE of one side increased from 5.1% postoperative 1 day to 7.7% postoperative 14days. PE of bilateral TKA increased from 11.8% postoperative 1 day to 17.6% postoperative 14days. PE frequency of both postoperative one day and postoperative 14 days were significant difference between one side TKA and bilateral TKA.
All DVT cases were treated using some anti-thrombosis drug, because these case didn’t have any sever symptoms. But, PE cases were treated using heparin immediately to avoid deadly events.