Incidence and preventive treatment for deep vein thrombosis with our own preventive protocol in total hip and knee arthroplasty

• Published in: PloS one Vol. 19; no. 1; p. e0293821
• Main Authors: Momose, Takashige, Nakano, Masaki, Nakamura, Yukio, Maeda, Takashi, Nawata, Masashi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17.01.2024; Public Library of Science (PLoS)
• Subjects: Aged; Anticoagulants; Arthritis; Arthritis, Rheumatoid - complications; Arthroplasty (knee); Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee - adverse effects; Biomedical materials; Body mass index; Disease prevention; Drug therapy; Femur; Hip; Humans; Incidence; Joint replacement surgery; Knee; Medicine and Health Sciences; Necrosis; Orthopaedic implants; Osteoarthritis; Patients; Physical therapists; Postoperative Complications - etiology; Prevention; Pulmonary Embolism - surgery; Rheumatoid arthritis; Rheumatoid factor; Risk Factors; Thromboembolism; Thrombosis; Total hip arthroplasty; Ultrasonic imaging; Veins; Veins & arteries; Venous Thromboembolism - etiology; Venous thrombosis; Venous Thrombosis - diagnostic imaging; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0293821

The aim of the present study was to investigate the perioperative and postoperative incidence of deep vein thrombosis (DVT) and validate the effectiveness of our own preventive treatment protocol for venous thromboembolism (VTE) occurrence in lower extremity arthroplasty patients. The subjects were 1,054 patients (mean age: 74.3 years) who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) at our institutions between April 2014 and March 2017. We examined the frequencies of pre- and post-operative DVT by lower extremity Doppler images, and the incidence rate at proximal or distal regions as well as that according to preoperative DVT status were evaluated. Preoperative DVT was detected in 6.5% (69 cases) of our cohort and those were located 1.4% (15 cases) at proximal and 5.1% (54 cases) at distal regions. A significantly higher rate of postoperative DVT development was observed in preoperative DVT+ THA patients (P = 0.0075), but not in TKA patients only with a higher tendency (P = 0.56). The overall incidence of DVT up to 2 weeks after surgeries was 27.3% (288 cases); however, the rate in proximal femur regions was suppressed to 2.8% (30 cases), and there was no symptomatic pulmonary thromboembolism (PTE) case. The results demonstrated the importance of regular Doppler examination for early detection of postoperative DVT occurrence and the following immediate treatment initiation. Our own VTE preventive treatment protocol could reduce the development of proximal DVT, and the periodic monitoring as well as prompt treatment might prevent the fatal PTE. osteoarthritis (OA), rheumatoid arthritis (RA).