Lower extremities' postthrombotic syndrome after total knee arthroplasty.
BACKGROUND
Deep venous thrombosis (DVT) is a disease associated with high morbidity in 40-60% patients who underwent Total Knee Arthroplasty (TKA). Postthrombotic syndrome (PTS) is a common long-term complication that may develop within 6 months or more than 2 years after episode of DVT.


OBJECTIVE
To examine the prevalence of PTS in patients who had history of previous DVT and non-previous DVT at least 2-year follow-up period after TKA.


METHODS
Retrospective chart review was done. All patients who underwent TKA during October 2002-2005 were included. They were postoperatively assessed for PTS with Villalta score and duplex ultrasonography at > or =2 years. The confirmed diagnosis of DVT was done by contrast venography.


RESULTS
22 of 76 patients (56 previous DVT 20 non-previous DVT) had PTS based on the clinical assessment. The previous-DVT group had significantly higher risk to PTS (OR = 1.59; 95% CI: 1.294-1.949; p-value = 0.001). When diagnosed with duplex ultrasonography, 36 in 56 patients of previous-DVT group and 8 in 20 of non-previous-DVT group were found positive venous reflux. Most of venous reflux occurred at popliteal vein (77%) and posterior tibial vein (59%).


CONCLUSIONS
After TKA, the patients who developed DVT had higher risk to PTS (OR = 1.588). Treatment of DVT may not decrease this risk. Prevention of DVT becomes an important approach to prevent PTS.
Khuangsirikul
Saradej
S
Department of Orthopaedics, Phramongkutklao Hospital, Bangkok 10400, Thailand.
Sampatchalit
Sudsriluk
S
Foojareonyos
Trakool
T
Chotanaphuti
Thanainit
T
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D010690:Phlebography; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011186:Postphlebitic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis