ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #962

 

Are There Clinical Meaning on Asymptomatic Pulmonary Embolism After Total Knee Arthroplasty?

Atsushi Sato, MD, PhD, Koto-Ku, Tokyo JAPAN
Takayuki Koya, MD, PhD, Koto-Ku, Tokyo JAPAN
Hiroshi Takagi, MD, PhD, Yokohama, Kanagawa JAPAN
Jun Oike, MD, Yokohama, Kanagawa JAPAN
Saki Yagura, MD, Yokohama, Kanagawa JAPAN
Takayuki Okumo, MD, PhD, Yokohama, Kanagawa JAPAN
Naoki Okuma, MD, Yokohama, Kanagawa JAPAN
Shin Kato, MD, PhD, Yokohama, Kanagawa JAPAN
Masahiko Maekawa, MD, PhD, Yokohama, Kanagawa JAPAN
Fumiyoshi Kawashima, MD, Tokyo JAPAN
Soshi Asai, MD, Yokohama, Kanagawa JAPAN
Kazunari Tomita, MD, PhD, Tokyo JAPAN

Department of Orthopedic Surgery, Showa University Koto Toyosu Hospital, Tokyo, JAPAN

FDA Status Not Applicable

Summary

The incidence of pulmonary embolism was significantly higher in one-staged bilateral TKA, It has to be considered CE-CT at least for the patients who undertake bilateral TKA.

Abstract

Total knee arthroplasty (TKA) is one of the most successful surgeries to relieve pain and dysfunction caused by severe arthritis. However, it is still debated that there is a necessity on anticoagulant for Deep vein thrombosis (DVT) and pulmonary embolism (PE) after TKA. Therefore, we prospectively investigated the incidence of DVT/PE after primary TKA by contrast enhanced computed tomography (CE-CT) and venous ultrasonography (US) in Japanese Patients.

Methods

One hundred and fourteen patients who underwent primary TKA from January 2015 to June 2016 were applied. The mean age was 75.0 years and average BMI was 25.0. There were 105 cases of osteoarthritis and 7 of rheumatoid arthritis. A single knee surgery team performed all operations with cemented type prostheses. There were 47 cases of one-staged bilateral TKA and 67 of unilateral TKA. CE-CT and venous US were performed at the 4th day after surgery. These images were read by a single senior radiologist team.

Results

CE-CT was performed in 90 patients (78.9%) and US was in all patients. The incidence of DVT was 63 patients (55.2%) and asymptomatic PE was 11 patients (9.6%). Then we compared the incidence between one-staged bilateral TKA group and Unilateral group. DVT was 30 (63.8%) and 33 (49.2%) respectively. Asymptomatic PE was eight (17.0%) and three (4.4%) respectively, and there was significant difference on the incidence between two groups.

Conclusion

We prospectively investigated 114 patients for DVT/PE after primary TKA using CE-CT and venous US. There was significant difference on the incidence of asymptomatic PE between one-staged bilateral TKA group and Unilateral group. Thus, using CE-CT should be taken into account to investigate asymptomatic PE at least for the patients who undertake bilateral TKA.