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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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Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Efficacy of Functional Alignment Technique In Robotic-Arm Assisted Total Knee Arthroplasty ePoster Presentation Masashi Tamaki, MD, PhD, JAPAN Yuki Yamauchi, MD,PhD, JAPAN Seishiro Higa, MD, JAPAN Tomoyuki Shimakawa, MD, JAPAN Yuki Isobe, MD, JAPAN Teruya Ishibashi, MD,PhD, JAPAN Shoji Konda, PhD, JAPAN Tetsuya Tomita, M.D.,Ph.D , JAPAN
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
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
Evaluation of The Safety And Efficacy of The Fully Automated Active Robotic System In Robotic Assisted Total Knee Arthroplasty ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
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
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
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
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
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
Same Complication Rate After Day-Case Procedure Or Fast-Track Procedure After Total Hip And Knee Arthroplasty. A Prospective, Propensity Score-Matched Case-Control Study ePoster Presentation Jean-Yves Jenny, Prof., FRANCE Vincent Gisonni, MD, FRANCE
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA

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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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