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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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Participation of Physical Activity Following Knee Arthroplasty: A Meta-Analysis ePoster Presentation Ahmed A Magan, BM BSc (Hons) MRCS (Eng) FRCS (Eng) Trauma & Orth, UNITED KINGDOM Babar Kayani, BSc (HONS), MBBS, MRCS (Eng), UNITED KINGDOM Warran Wignadasan, MBBS, BSc (Hons), MRCS, UNITED KINGDOM Dia Eldean Giebaly, MBChB, MSc, FRCS, EMBA, UNITED KINGDOM Flaminia Ronca, PHD, UNITED KINGDOM Fares S. Haddad, MCh(Orth), BSc, FRCS(Orth), UNITED KINGDOM
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Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty ePoster Presentation James Gill, MB BChir, BSc, FRCS, UNITED KINGDOM McMeniman J Peter, AUSTRALIA Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, AUSTRALIA Daniel Johnson Brimm, BSc, MD, AUSTRALIA Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA
Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years. ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa Gabriel Gaggiotti, MD, ARGENTINA
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Palliative Arthroscopic Debridement with Continuous Irrigation for the Infection TKA of High Mortality Risk Patients ePoster Presentation Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Yoon Cheol Nam, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF
Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
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
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
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

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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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