TITLE:
Clinical, Laboratory and Echografic Evaluation of Patients with Deep Vein Thrombosis Following Total Knee Arthroplasty
AUTHORS:
Carlos Roberto Schwartsmann, Mario Arthur Rockenbach Binz, Marco Tonding Ferreira, Felipe Roth, Ivan Fadanelli Simionato, Leandro de Freitas Spinelli, João Pedro Farina Brunelli
KEYWORDS:
Knee Arthroplasty, DVT, Knee Replacement
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.9 No.2,
February
14,
2019
ABSTRACT: Introduction: Total
knee arthroplasty, being a major surgery, carries a risk of post-operative deep
vein thrombosis (DVT). The main objective of the present study was to elucidate
the association of clinical, laboratory, and echographic findings with the
occurrence of DVT. Patients and Methods: The present study was
prospective and non-randomized, with restricted exclusion criteria. Forty
patients were submitted to total knee arthroplasty due to osteoarthritis.
Patients were clinically evaluated by laboratory tests, assessment of pain and
calf circumference, and the presence of Homans’ sign. Echo Doppler was
performed in each patient on postoperative day 7. The echographic evaluation
divided the patients into two groups: positive (G1) and negative for thrombosis
(G2). All patients received prophylactic heparin during the 7-day hospital
admission. Results: Eleven patients complained of pain (analgesic
medication was used during the entire admission). Leg circumference variation
from the pre-operative period to post-operative day 7 was: G1, 1.70 ± 1.12 cm
and G2, 0.68 ± 1.25 cm (p = 0.03). Homans’ sign was considered positive in 10
patients. Echographic evaluation was positive in 11 patients (27.5%). No cases
of pulmonary embolism, infection, or death were observed. Conclusions: The incidence of DVT was 27.5%, with an increase in leg circumference being the
main predictive factor (p = 0.03).