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Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS
INDIA

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Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS, INDIA

maharishi markandeshwar medical college and hospital , kumarhatti, Himachal pradesh, INDIA

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Total Joint Replacement

Diagnosis Method

Physical Examination MRI

Summary: though DVT events despite prophylaxis reflect questions about the preventability of post-injury DVT. But in this clinical study Mechanical prophylaxis as an adjunct to Pharmacologic prophylaxis’s helps in reduction of incidence of DVT significantly

Purpose

-Deep vein thrombosis (DVT), a common type of venous thrombosis, and its complication, pulmonary embolism (PE), can be life threatening. It is associated with increased morbidity and mortality. The association between total knee replacement(TKR) and Venous thromboembolism (VTE) has been recognized for almost a century. After a TKR, the incidence of VTE varies from 7% to 58%, depending on patient demographics, mechanism of injury, diagnoses, and type of VTE prophylaxis used
Different types of VTE prophylaxis used are mechanical or pharmacologic. Supported by high-quality evidence, pharmacologic thromboprophylaxis is recommended for high risk trauma patients . This prospective study was done with a primary aim to determine the incidence and nature of DVT in TKR patients and also to assess the superiority of mechanical thromboprophylaxis+ pharmacologic prophylaxis’s as compared pharmacologic prophylaxis’s on the incidence of DVT in lower limb trauma patients
Methods- This prospective observational study included 336 patients age 58 years or older who presented with TKR admitted into the orthopaedic unit. Those filling inclusion criteria underwent lower-limb Colour doppler ultrasound at 48 hrs than 1 week during their hospital course to diagnose DVT further follow up ultrasound depend upon the clinical signs . Based on Venous Thromboembolism ( VTE ) Risk assessment tool and bleeding Risk assessment Group 1 was given mechanical prophylaxis in form of an intermittent pneumatic compression device (IPC) along with pharmacologic prophylaxis ( low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) and Group 2 was given pharmacologic prophylaxis alone.

Results

A total of 336 patients underwent extremity Doppler ultrasound to detect DVT and were given. VTE prophylaxis based in injury severity score.
Group 1 : Total 164 patients received ( IPC+ LMWH) and only 3 ( 1.82%) patients developed DVT
Group 2: Total 172 patients (LMWH) and 24 (13.9%) patient develop DVT despite prophylaxis’s

Group 1 vs Group 2 shows significant difference with P value < 0.05. Over all incidence of DVT detected in both groups are 8.04% and proximal DVT 23(6.84%) and only 4 distal DVT (1.19%) patients showed recanalization within 3 months post operatively without single episode of PE. Prevalent DVT was not detected in any patients. Overall, no in-hospital deaths were related to DVT and/or PE.
Hence it can be concluded that though DVT events despite prophylaxis reflect questions about the preventability of post-injury DVT. But in our preventive clinical study Mechanical prophylaxis as an adjunct to Pharmacologic prophylaxis’s helps in reduction of incidence of DVT significantly so we recommend the usage of IPC along with Pharmacological prophylaxis in patients of total knee replacement.

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Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty. ePoster Presentation Ryota Yamagami, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Takahiro Arakawa, MD, JAPAN Hiroshi Inui, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Lateral Unicompartmental Knee Arthroplasty (UKA) Showed a Lower Risk of Failure Compared to Medial Unicompartmental Knee Arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO) ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Barbara Bordini, Stat, ITALY Stefano Fratini, MD, ITALY Cristina Ancarani, Stat, ITALY Piero Agostinone, MD, ITALY Alberto Grassi, PhD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Differences In Pain, Sleep Status And Functional Recovery Between TKA And UKA ePoster Presentation Takeo Mammoto, MD, JAPAN
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty ePoster Presentation Yushi Sakamoto, MD, JAPAN Shinichiro Nakamura, MD, PhD, JAPAN Yugo Morita, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Yusuke Yamawaki, MD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Association Of Ischemia Time And Serum Lactate Levels With Postoperative Pain In Primary Total Knee Arthroplasty At The Orthopedics And Traumatology Service At The Unidad Médica De Alta Especialidad No. 1 Bajío. ePoster Presentation Juan Antonio García Ramírez, MD, MEXICO

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Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

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Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study

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