title: Contrast-enhanced Computed Tomography Screening Is Effective for Detecting Venous Thromboembolism not Prevented by Prophylaxis after Total Knee Arthroplasty.
abstract: Venous thromboembolism (VTE) is a potential complication occurring after total knee arthroplasty (TKA). We investigated the incidence of VTE after TKA using contrast-enhanced computed tomography (CT), and assessed the efficacy of VTE prophylaxis (fondaparinux and enoxaparin). At our hospital, 189 patients (225 knees) underwent TKA between April 2007 and October 2011. The 225 knees were divided into a control group with no VTE prophylaxis (31 cases), a fondaparinux group (107 cases), and an enoxaparin group (87 cases). Contrast-enhanced CT screening for VTE was performed in all cases on day 5 or 6 after TKA. D-dimer levels were measured on day 5 after TKA, and were significantly lower in the fondaparinux (9.8 ± 3.8) and enoxaparin groups (9.4 ± 4.9) than in the control group (15.6 ± 9.8) (p ＜ 0.001). However, no statistically significant difference in the incidence of VTE was observed among the groups (control, 61.3%;fondaparinux, 49.5%;enoxaparin, 50.6%). Prophylaxis was not effective for the prevention of VTE as detected by contrast-enhanced CT after TKA. CT should be performed after TKA, even when VTE prophylaxis is used.
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan .yukimasaokada@gmail.com.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Okada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Furumatsu
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazawa
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Masataka
authors.initials: M
authors.lastname: Fujii
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Abe
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed / Q000379:methods*; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging* / Q000517:prevention & control
chemical_list: D003287:Contrast Media