title: Obesity and Venous Thromboembolism in Total Knee Arthroplasty Patients in an Asian Population.
abstract: Venous thromboembolism (VTE) is a known complication of total knee arthroplasty (TKA). In addition, obesity has been implicated as a risk factor and justification for chemoprophylaxis for VTE. We wanted to review the prevalence of VTE among our patients and evaluate the incidence rates of VTE among nonobese and obese patients.
  
  
  
  We reviewed 894 patients who underwent elective unilateral total knee arthroplasty by a single surgeon from March 2003 to November 2014 in our center. Any patients with clinically significant symptoms or signs of VTE such as deep venous thrombosis (DVT) or pulmonary embolism (PE) were diagnosed radiologically. The patient demographics analyzed included age, gender, body mass index, the number of comorbid diseases, and a history of hyperlipidemia.
  
  
  
  We found the incidence of VTE of 0.67% in our patients (6 patients of 894). Four of the 6 patients (66.7%) who developed DVT and PE belonged to nonobese group. The frequency of VTE in nonobese patients was 0.65% and 0.73% in the obese patients. There were no significant differences in age, number of comorbidities, and a history of hyperlipidemia between those who developed DVT and PE and those who did not.
  
  
  
  With the low prevalence of VTE among our study population, including patients with obesity, advanced age, multiple comorbidities, or hyperlipidemia, the practice of routine chemoprophylaxis should be reviewed.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Kenny
authors.initials: K
authors.lastname: Tay
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Hamid Rahmatullah
authors.initials: HR
authors.lastname: Bin Abd Razak
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Andrew Hwee Chye
authors.initials: AH
authors.lastname: Tan
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D044466:Asian People; D018890:Chemoprevention; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011655:Pulmonary Embolism / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology*
keywords: Asians; chemoprophylaxis; obesity; total knee arthroplasty; venous thromboembolism