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Mechanical thromboprophylaxis would suffice after total knee arthroplasties in Asian patients?

Title
Mechanical thromboprophylaxis would suffice after total knee arthroplasties in Asian patients?
Authors
Kim Y.-H.Anil V.Gaurav A.Park J.-W.Kim J.-S.
Ewha Authors
김영후김준식박장원
SCOPUS Author ID
김영후scopus; 김준식scopus; 박장원scopus
Issue Date
2019
Journal Title
Archives of Orthopaedic and Trauma Surgery
ISSN
0936-8051JCR Link
Citation
Archives of Orthopaedic and Trauma Surgery vol. 139, no. 2, pp. 167 - 171
Keywords
Chemical thromboprophylaxisMechanical compression devicePrevalence deep vein thrombosisPulmonary embolismTotal knee arthroplasty
Publisher
Springer Verlag
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Purpose: Our prospective study evaluated the incidence and location of deep vein thrombosis (DVT), the risk factors for PE and the natural history of DVT after TKA in patients who have received only mechanical compression device without having any chemical thromboprophylaxis or therapeutic treatment. Methods: We studied 408 consecutive patients (691 knees) who underwent primary TKA; 283 patients had one-stage bilateral TKAs and 125 had unilateral TKAs. Coagulation assays, the full blood count and blood typing tests, and serum chemical profiles were undertaken in all patients on three separate occasions. Molecular genetic testing was performed preoperatively to detect the genetic traits involving DVT. Bilateral simultaneous or unilateral venograms were carried out at 6 or 7 days after operation. Perfusion lung scanning was undertaken before and at 7 or 8 days after operation. Results: In the 691 venograms in 408 patients, only 4 knees (0.6%) were positive for fresh thrombi. In the 4 knees with DVT, thrombi were located in the calf veins. We observed factor V Leiden mutation, antithrombin-III level, and prothrombin promoter G20210A mutation were absent in all patients. We saw no relationship between DVT and coagulation or thrombophilic data. No pulmonary embolism (PE) occurred as shown by negative perfusion lung scan and absence of symptoms. Conclusion: We concluded that the combinations of absent thrombophilic polymorphisms with low clinical prothrombotic risk factors led to low prevalence of DVT and virtually absent PE after TKA in the current series of patients, who had received mechanical compression device only without chemical thromboprophylaxis. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
DOI
10.1007/s00402-018-3045-3
Appears in Collections:
의과대학 > 의학과 > Journal papers
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