The incidence of deep vein thrombosis and pulmonary embolism after total knee arthroplasty: the screening study by radionuclide venography.
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are considered uncommon in Asian populations and thrombo-prophylaxis is rarely indicated. The objective of this study was to investigate the incidence of DVT and PE after total knee replacement in an Asian population.


METHODS
There were 100 patients who underwent total knee replacement enrolled in this study. No thrombo-prophylaxis was given to these patients. The possible risk factors such as age, sex, body mass index (BMI), operative time and the post-operative blood loss were recorded.


RESULTS
The duplex ultrasonography (controlled) showed no evidence of DVT in all cases. There were 67 patients who completed radionuclide venography in this study. The incidence of DVT from positive radionuclide venography was 24% (16/67 patients) and PE was 12% (8/67 patients). All patients with positive imaging studies were asymptomatic. The risk factors were similar in both groups.


CONCLUSIONS
The incidence of DVT and PE in post-operative total knee replacement surgery, although lower than the incidence in Western populations, is higher than previously assumed. The radionuclide venography is less invasive and a useful diagnostic method for both DVT and PE. Because all patients with DVT and PE are asymptomatic, the use of thrombo-prophylaxis should be considered for risk and benefit.
Department of Orthopaedics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. racpk@mahidol.ac.th
Chathchai
C
Pookarnjanamorakot
Rojana
R
Sirisriro
Charindr
C
Eurvilaichit
Suphaneewan
S
Jaovisidha
Isara
I
Koysombatolan
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D015994:Incidence; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011877:Radionuclide Imaging; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology