Clinical, Laboratory and Echografic Evaluation of Patients with Deep Vein Thrombosis Following Total Knee Arthroplasty

Abstract

Introduction: Total knee arthroplasty, being a major surgery, carries a risk of post-operative deep vein thrombosis (DVT). The main objective of the present study was to elucidate the association of clinical, laboratory, and echographic findings with the occurrence of DVT. Patients and Methods: The present study was prospective and non-randomized, with restricted exclusion criteria. Forty patients were submitted to total knee arthroplasty due to osteoarthritis. Patients were clinically evaluated by laboratory tests, assessment of pain and calf circumference, and the presence of Homans' sign. Echo Doppler was performed in each patient on postoperative day 7. The echographic evaluation divided the patients into two groups: positive (G1) and negative for thrombosis (G2). All patients received prophylactic heparin during the 7-day hospital admission. Results: Eleven patients complained of pain (analgesic medication was used during the entire admission). Leg circumference variation from the pre-operative period to post-operative day 7 was: G1, 1.70 ± 1.12 cm and G2, 0.68 ± 1.25 cm (p = 0.03). Homans' sign was considered positive in 10 patients. Echographic evaluation was positive in 11 patients (27.5%). No cases of pulmonary embolism, infection, or death were observed. Conclusions: The incidence of DVT was 27.5%, with an increase in leg circumference being the main predictive factor (p = 0.03).