Incidences of Deep Vein Thrombosis and Pulmonary Embolism after Total Knee Arthroplasty Using a Mechanical Compression Device with and without Low-Molecular-Weight Heparin

Abstract

PurposeTo investigate the incidence of thromboembolic events and complications related to bleeding after total knee arthroplasty (TKA) with a mechanical compression device alone or in combination with low-molecular-weight heparin (LMWH).Materials and MethodsA total of 489 TKA patients (776 knees) were retrospectively reviewed for the incidence of thromboembolic events and complications related to bleeding. While 233 patients (354 knees) were treated with a mechanical compressive device without LMWH, 256 patients (422 knees) were treated with the mechanical compressive device along with LMWH.ResultsThe incidences of deep vein thrombosis (DVT) and pulmonary embolism (PE) were 15 of 375 knees (4.0%) and 5 of 375 knees (1.3%), respectively, in the group that used only a mechanical compressive device, and 14 of 401 knees (3.4%) and 5 of 401 knees (1.2%), respectively, in the group that used the mechanical compressive device with LMWH. There was no significant difference between the two groups (p=0.125 and p=0.146, respectively). The postoperative hemovac drainage amount was 635±57 mL in the group with a mechanical compressive device only and 813±84 mL in the group with the device and LMWH; therefore, the amount of drainage was significantly greater in the latter group (p=0.013).ConclusionsMechanical compression alone for prophylaxis against DVT and PE after TKA can be an attractive option in Korean patients.

Incidence of deep vein thrombosis before and after total knee arthroplasty without pharmacologic prophylaxis: a 128-row multidetector CT indirect venography study

“…Deep vein thrombosis (DVT) is a frequent and significant complication after total knee arthroplasty (TKA) [ 1 , 2 ]. However, the incidence, diagnosis, prevention, and treatment of DVT remain controversial [ 1 , 3 – 9 ].…”

“…Differences in the DVT incidence between Asian and Western populations may have aggravated the controversies [ 10 – 14 ]. Most recent studies have recorded lower incidences of DVT in Asian patients; routine pharmacological prophylaxis is not recommended [ 1 , 2 , 6 ]. Indeed, studies on the use of mechanical compression devices (alone) to prevent DVT have become more common [ 1 , 2 , 6 , 15 ].…”

“…Most recent studies have recorded lower incidences of DVT in Asian patients; routine pharmacological prophylaxis is not recommended [ 1 , 2 , 6 ]. Indeed, studies on the use of mechanical compression devices (alone) to prevent DVT have become more common [ 1 , 2 , 6 , 15 ]. However, theoretically, the use of such devices alone, thus without pharmacological treatment, would be less effective than the combination.…”

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?

“…Moreover, in line with the previous studies, 18,24 BMI was significantly correlated with the occurrence of DVT. Although there are several studies regarding the incidence of VTE following TKA, 5,7,9,25 few studies have reported the incidence of VTE following HTO (►Table 6). 10,26,27 Some studies reported the incidence of VTE after lateral closed-wedge HTO (LCWHTO) in the Western population, which is higher than that observed in our study.…”

Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty

“…Mechanical thromboprophylaxis, early postoperative mobilization, and shorter hospital stays have led some to question whether routine chemoprophylaxis is still necessary [ 6 , 7 ]. Moreover, the incidence of VTE among Asians is generally thought to be lower compared to their Western counterparts [ 8 – 11 ]. In a systematic review of Asian patients undergoing TKA without thromboprophylaxis, Kanchanabat et al, using venography, found that the incidence of proximal DVT, distal DVT, and symptomatic PE was 8.7%, 30.0%, and 0.5%, respectively [ 8 ].…”