title: Mechanical thromboembolic prophylaxis with risk stratification in total knee arthroplasty.
abstract: The purpose of this study was to determine the rate of thromboembolic and bleeding complications when using mechanical prophylaxis with preoperative risk stratification following total knee arthroplasty (TKA). Between 1994 and 2007, 4037 TKAs were performed on 3144 patients at our institution. Mechanical VTE prophylaxis was used for standard risk patients, which included AV impulse foot pumps, thigh high stockings, and early mobilization. Chemoprophylaxis was only given to patients who were at increased thromboembolic risk. The incidence of DVT identified by ultrasound following TKA was 2.1%. A retrospective review showed 1 patient had a fatal pulmonary embolism, and 5 patients had bleeding complications in the knee. We conclude that mechanical thromboembolic prophylaxis using risk stratification is safe and effective following TKA.
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia.
authors.forename: William G
authors.initials: WG
authors.lastname: Hamilton
authors.affiliation: Town Center Orthopaedic Associates, Centreville, Virginia.
authors.forename: James D
authors.initials: JD
authors.lastname: Reeves
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Fricka
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia.
authors.forename: Nitin
authors.initials: N
authors.lastname: Goyal
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia.
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Engh
authors.affiliation: Anderson Orthopaedic Research Institute, Alexandria, Virginia.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Parks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004434:Early Ambulation; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology; D011655:Pulmonary Embolism / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D053828:Stockings, Compression; D014463:Ultrasonography; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
keywords: DVT prophylaxis; continuous passive motion; risk stratification; total knee arthroplasty; venous thromboembolism