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Knee Surg Relat Res. 2012 Mar;24(1):19-24. doi: 10.5792/ksrr.2012.24.1.19. Epub 2012 Feb 28.

Incidence of venous thromboembolism using 64 channel multidetector row computed tomography-indirect venography and anti-coagulation therapy after total knee arthroplasty in Korea.

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  • 1Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

PURPOSE:

This study evaluated the incidence of a venous thromboembolism (VTE) after total knee arthroplasty (TKA) using multidetector row computed tomography-indirect venography (MDCT-indirect venography) and assessed the efficacy of anti-coagulation therapy.

MATERIALS AND METHODS:

We enrolled 118 patients with 126 cases of TKA. The average age of the patients was 68.4 years. We used 64 channel MDCT-indirect venography for the detection of VTE. We treated selectively proximal deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) cases according to the results of MDCT-indirect venography. We re-evaluated the change in VTE using follow-up MDCT-indirect venography after 3 months.

RESULTS:

We identified VTE in 35.7%. DVT only was identified in 22.2% including 8 cases of proximal DVT and 20 cases of distal DVT. PTE without DVT was identified in 4.8%, and combined DVT and PTE in 8.7%. All patients with PTE were asymptomatic, but 4 DVT patients had signs of leg swelling. After anti-coagulation therapy, 20 patients showed complete resolution in 16 cases, improvement in 3 cases and one case showed a new distal DVT.

CONCLUSIONS:

The incidence of VTE after primary TKA was 35.7% in Korea. Furthermore, anti-coagulation therapy for proximal DVT and PTE patients may be a useful method for preventing the occurrence of a fatal PTE.

KEYWORDS:

Deep vein thrombosis; Indirect venography; Multidetector-row computed tomography; Pulmonary thromboembolism; Total knee arthroplasty; Venous thromboembolism

PMID:
22570848
[PubMed]
PMCID:
PMC3341814
Free PMC Article
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