title: Venous hemodynamic alterations in lower limbs undergoing total joint arthroplasty.
abstract: Using duplex ultrasonography, we measured preoperative and postoperative venous flow volume in 32 operated lower limbs without deep vein thrombosis (DVT) after total hip arthroplasty (THA, n = 17) and total knee arthroplasty (TKA, n = 15). We also calculated percentage decrease in mean venous flow volume (MVFV) from before surgery to after surgery. Patients with a history of one of several venous diseases, congestive heart failure, or morbid obesity were excluded. In both groups (THA, TKA), MVFV 3 days after surgery and MVFV 1 week after surgery were significantly lower than preoperative MVFV, but MVFV at 2 or more weeks after surgery did not differ significantly from preoperative MVFV (result 1). Incidentally, the decrease in MVFV in the lower limbs was significantly larger 3 days after TKA than 3 days after THA (result 2). As venous stasis has a central role in thrombus formation, result 1 suggests that the risk for DVT initiation is low at 2 or more weeks after THA and TKA in patients with normal preoperative venous physiologic functions. Result 2 is probably correlated with the evidence that DVT incidence is higher after TKA than after THA.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors.forename: Kousuke
authors.initials: K
authors.lastname: Sasaki
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Miura
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takasugi
authors.forename: Seiya
authors.initials: S
authors.lastname: Jingushi
authors.forename: Eiji
authors.initials: E
authors.lastname: Suenaga
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011184:Postoperative Period; D057234:Preoperative Period; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000209:etiology* / Q000503:physiopathology