Changes in LPIA D-dimer levels after total hip or knee arthroplasty relevant to deep-vein thrombosis diagnosed by bilateral ascending venography.
The purpose of the current retrospective study was to determine the most sensitive and specific cutoff value of plasma D-dimer level associated with deep-vein thrombosis (DVT) after total hip (THA) or knee (TKA) joint arthroplasty. Diagnosis of DVT was determined by bilateral ascending venography pre- and postoperatively. Plasma D-dimer levels were measured by a latex photometric immunoassay system (LPIA) preoperatively and postoperatively on days 1, 3, 7, 10, 14, and 21. Postoperative DVT diagnosed by venography was found in 22 patients (40.1%) after THA and in 18 patients (64.3%) after TKA. Plasma D-dimer levels were significantly higher ( P < 0.01) in patients with DVT than in those without DVT on days 1, 7, and 10 after THA, but only on day 7 after TKA. Statistical analysis confirmed that a cutoff value of 10.0 microg/ml for D-dimer on day 7 was most sensitive (THA, 95.5%; TKA, 94.4%) and most specific (THA, 96.9%; TKA, 90.0%) in the diagnosis of DVT after THA as well as TKA. It was concluded that over 10 microg/ml of LPIA D-dimer on postoperative day 7 appears to be an indication of the occurrence of DVT after THA and TKA.
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Naofumi
N
Shiota
Toru
T
Sato
Keiichiro
K
Nishida
Masatsugu
M
Matsuo
Yasuhiro
Y
Takahara
Shigeru
S
Mitani
Takuro
T
Murakami
Hajime
H
Inoue
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D015415:Biomarkers / Q000032:analysis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011184:Postoperative Period; D011300:Preoperative Care; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D