Deep Vein Thrombosis after Joint Arthroplasty in Lower Extremity: Venography versus Color Doppler Ultrasonography

Lee, Keun Bae; Song, Eun Kyu; Seon, Jong Keun; Kim, Jae Kyu

Abstract

PURPOSE: Deep vein thrombosis (DVT) after joint arthroplasty in the lower extremity has been a major cause of death postoperatively. However, there is few reports on incidence and risk factors of DVT in Korea. We evaluated the incidence of DVT, correlation between the DVT, and risk factors and effectiveness of color doppler ultrasonography for diagnosis of DVT after joint arthroplasty in the lower extremity.
MATERIALS AND METHODS
One hundred and six cases (99 patients) of total hip or knee arthroplasties from March 1996 to August 1997 were included in this study. There were forty-four total hip arthroplasties and sixty-two total knee arthroplasties. No patients received prophylactic agents for DVT. Venogram and color doppler ultrasonogram were obtained within 7 days preoperatively and in 7 to 14 days postoperatively. Only venography was performed in 45 cases and both venography and color doppler ultrasonography were performed in 61 cases. RESULT: On venogram, there were no evidence of thrombi in all cases preoperatively but thrombi were observed in 9 cases (8.5%) postoperatively. Among these positive cases, eight cases showed thrombi in the calf vein and one case in the femoral vein. Color doppler ultrasonography could not detect any thrombi among 3 cases which had positive findings with venogram. In contrast to other reports, we did not identify a correlation between DVT and so-called risk factors such as age, tourniquet time, BMI (body mass index), diastolic blood pressure, operation time and coagulation assay (platelet, PT, aPTl, Anti-thrombin III, fibrinogen)
CONCLUSIONS
We concluded that color doppler ultrasonography may not be an effective method in the diagnose is of DVT of calf vein in asymptomatic patients and that so-called risk factors had no relation to DVT.