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

Incidence of Venous Thromboembolism Using 64 Channel Multidetector Row Computed Tomography-Indirect Venography and Anti-Coagulation Therapy after Total Knee Arthroplasty in Korea

• Park KH
• Cheon SH
• Lee JH
• Kyung HS

• KMID: 2223441
• DOI: http://doi.org/10.5792/ksrr.2012.24.1.19

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.

Keyword

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

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Incidence
Knee
Korea
Leg
Multidetector Computed Tomography
Phlebography
Pulmonary Embolism
Venous Thromboembolism
Venous Thrombosis