title: Deep vein thrombosis after elective knee surgery. An incidence study in 312 patients.
abstract: The incidence of venous thromboembolism after elective knee surgery has previously been studied almost exclusively in patients receiving total knee replacements, in whom the risk of a deep vein thrombosis is approximately 60%. We report the results of ipsilateral ascending venography in 312 patients undergoing a wide variety of elective knee operations under tourniquet ischaemia, none of whom received any specific prophylaxis against thromboembolism. Total knee replacement was confirmed to carry a high risk with ipsilateral deep vein thrombosis in 56.4% and symptomatic pulmonary embolism in 1.9%. By contrast, arthroscopy was associated with a low incidence of venous thrombosis (4.2%). Meniscectomy, arthrotomy, patellectomy, synovectomy and arthrodesis were all high-risk procedures, particularly in patients over 40 years of age, and were associated with deep vein thrombosis rates of 25% to 67%. On the basis of these findings, we advise prophylaxis against venous thromboembolism in all patients over 40 years of age undergoing elective knee surgery other than arthroscopy.
authors: Thrombosis Research Unit, King's College Hospital, London, England.
authors: M D
authors: MD
authors: Stringer
authors: C A
authors: CA
authors: Steadman
authors: A R
authors: AR
authors: Hedges
authors: E M
authors: EM
authors: Thomas
authors: T R
authors: TR
authors: Morley
authors: V V
authors: VV
authors: Kakkar
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013927:Thrombosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000925:Anticoagulants