title: Deep vein thrombosis after total knee arthroplasty in asian patients without prophylactic anticoagulation.
abstract: Deep vein thrombosis (DVT) is an important complication following total knee arthroplasty (TKA). However, the incidence of DVT is generally underestimated due to subclinical or minor symptoms and signs. In Western countries, prophylactic agents against DVT are administered routinely after TKA. However, in Asia, no regular prophylaxis is generally given to patients undergoing TKA. This article presents a prospective study evaluating the incidence of DVT in 724 consecutive Taiwanese patients who underwent TKA without prophylactic anticoagulation therapy. Of these, 328 patients (45.3%) showed positive Homan's sign with calf swelling >3 cm. Ultrasonographic examination revealed the overall incidence of DVT to be 8.6% (62/724). The incidence of DVT was significantly higher in women (P=.035), in patients who underwent bilateral TKA (P=.002), and in patients with a body mass index ≥30 kg/m(2) (P=.026). The incidence of DVT appeared to be increased in patients with higher tourniquet time; however, the difference was not statistically significant. In all of the suspected cases of DVT, the symptoms subsided after the administration of enoxaparin with uneventful follow-up. No patient developed pulmonary embolism. Our results showed a relatively high incidence of DVT in an Asian population following TKA. We therefore consider that following TKA, prophylactic anticoagulation therapy should be administered to high-risk patients.
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Lien-Hsiang
authors.initials: LH
authors.lastname: Chung
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Chen
authors.forename: Cheng-Fong
authors.initials: CF
authors.lastname: Chen
authors.forename: Tain-Hsiung
authors.initials: TH
authors.lastname: Chen
authors.forename: Chien-Lin
authors.initials: CL
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000208:ethnology / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D044466:Asian People / Q000208:ethnology*; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D005271:Femur Head Necrosis / Q000208:ethnology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000208:ethnology / Q000601:surgery; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D020246:Venous Thrombosis / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin