Preoperative Evaluation of Soleal Vein Diameter by Ultrasound Is Beneficial for Prophylaxis of Deep Vein Thrombosis after Total Knee or Hip Arthroplasty

Abstract

Purpose The purpose of this retrospective study was to determine the association between preoperative soleal vein (SV) diameter and deep vein thrombosis (DVT) following total joint arthroplasty (TJA). Methods A total of 402 patients were enrolled, with 229 patients undergoing total knee arthroplasty (TKA) and 173 patients undergoing total hip arthroplasty (THA). Ultrasonography was performed 1-3 days preoperatively, on postoperative days 1, 3, and 7, or before discharge and during follow-up. The SV diameter was assessed preoperatively. Univariate analysis and multivariate logistic regression analysis were used to compare parameters between the DVT group and the non-DVT group. Results 78 patients (19.4%) were found to have DVT during hospitalization and after discharge and 14 patients (3.5%) developed symptomatic DVT. Multiple regression analysis showed that SV diameter, advanced age, and surgery type were independent predictors of postoperative DVT. In the logistic regression analysis for symptomatic DVT, SV diameter was found to be the only predictor. In the receiver operating characteristics (ROC) analysis for the value of SV diameter in diagnosing DVT, the area under curve (AUC) was 0.701 ((95% CI 0.636-0.766), P<0.001) and when the cut-off value of SV diameter was set at 0.57 cm, the sensitivity and specificity of SV diameter were 62.7% and 72.1%, respectively. Conclusions SV diameter was an independent risk factor for total and symptomatic DVT after TJA. Preoperative ultrasound screening of the SV diameter may be beneficial for the prevention of postoperative DVT.

The changes of the calf-vein deformation and femoral vein peak velocity during ankle pump exercise with or without graduated compression stockings

“…And the veins are therefore subjected to a more uniform pressure similar to intermuscular pressure. Some studies found that the intermuscular vein is the location where DVT often occurs, and soleus vein dilatation is an independent risk factor for deep venous thrombosis after orthopedic surgery [31,32]. Thus, the results obtained in this study could be considered as one of the possible mechanisms to explain that ankle pump exercise can prevent intramuscular venous thrombosis, which also needs to be further studied.…”

The application of Caprini Risk Assessment Model in evaluation of deep vein thrombosis for patients with end-stage osteoarthritis before arthroplasty

“…However, patients undergoing TKA were at high risk for VTE [7]. End-stage OA patients characterized with pain and high age could increase the risk for DVT [22,23]. To survey the incidence of surgery-related DVT, the incidence of patients showing DVT before surgery must be subtracted from the total of the incidences before and after surgery.…”

Characteristics and Treatment Strategy of Isolated Calf Deep Venous Thrombosis after Fractures: A Review of Recent Literature

“…ICDVTs were found in 33% (65/195) of 215 patients undergoing angiography, and calf muscular veins were the most common site. Yao et al 17 . studied the relationship between soleus vein thrombosis and joint replacement surgery and found that 78 (19.4%) of 402 patients had DVTs after total knee or hip replacement.…”

“…Yao et al . 17 studied the relationship between soleus vein thrombosis and joint replacement surgery and found that 78 (19.4%) of 402 patients had DVTs after total knee or hip replacement.…”