Incidence of Deep Vein Thrombosis and Venous Thromboembolism following TKA in Rheumatoid Arthritis versus Osteoarthritis: A Meta-Analysis

• Published in: PloS one Vol. 11; no. 12; p. e0166844
• Main Authors: Lee, Do-Kyung, Kim, Hyun-Jung, Lee, Dae-Hee
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 02.12.2016; Public Library of Science (PLoS)
• Subjects: Analysis; Arthritis; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - surgery; Arthroplasty (knee); Arthroplasty, Replacement, Knee - adverse effects; Asymmetry; Biocompatibility; Biology and Life Sciences; Care and treatment; Comparative analysis; Complications and side effects; Confidence intervals; Data processing; Embolism; Embolisms; Female; Health risk assessment; Humans; Incidence; Joint surgery; Knee; Male; Medicine and Health Sciences; Meta-analysis; Models, Biological; Osteoarthritis; Osteoarthritis, Knee - epidemiology; Osteoarthritis, Knee - surgery; Patients; Physical Sciences; Postoperative Complications - epidemiology; Preventive medicine; Research and Analysis Methods; Rheumatoid arthritis; Risk Factors; Studies; Surgical implants; Systematic review; Thromboembolism; Thrombosis; Veins & arteries; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology; Venous thrombosis; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0166844

This meta-analysis was designed to compare the incidence of deep vein thrombosis (DVT) and venous thromboembolism (VTE) following total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). All studies directly comparing the post-TKA incidence of DVT and/or VTE in patients with RA and OA were included. For all comparisons, odds ratios and 95% confidence intervals (CI) were calculated for binary outcomes. Six studies were included in the meta-analysis. The pooled data showed that the combined rates of asymptomatic and symptomatic DVT did not differ significantly in the RA and OA groups (1065/222,714 [0.5%] vs. 35,983/6,959,157 [0.5%]; OR 0.77, 95% CI: 0.57 to 1.02; P = 0.07). The combined rates of asymptomatic and symptomatic DVT and pulmonary embolism (PE) after TKA were significantly lower in the RA than in the OA group (1831/225,406 [0.8%] vs. 63,953/7,018,721 [0.9%]; OR 0.76, 95% CI: 0.62 to 0.93; P = 0.008). Conclusiviely, the DVT rates after primary TKA were similar in RA and OA patients. In contrast, the incidence of VTE (DVT plus PE) after primary TKA was lower in RA than in OA patients, despite patients with RA being at theoretically higher risk of thrombi due to chronic inflammation.