Risk factors for deep vein thrombosis even using low-molecular-weight heparin after total knee arthroplasty

Abstract

Background With an increase in deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in the Asian population, most surgeons today use a form of prophylactic anticoagulant agents in patients after TKA. Nevertheless, DVT occasionally develops even in these patients with prophylaxis. The purpose of this study was to identify the risk factors for DVT after TKA in cases of postoperative low-molecular-weight heparin (LMWH) use. Methods We designed a retrospective study with 103 patients who underwent primary TKA. From the second postoperative day, 60 mg of LMWH was subcutaneously injected into the patients daily. On the seventh postoperative day, patients had computed tomography angiography to check whether they had DVT. Regarding risk factors, we investigated patients’ gender, age, surgical site (unilateral/bilateral), body mass index, method of anesthesia, preoperative hypertension, diabetes, hypercholesterolemia status, and prothrombin time/international normalized ratio from electronic medical records. We analyzed the statistical significance of these risk factors. Results Statistically significant factors in the single-variable analysis were surgical site (unilateral/bilateral), body mass index, preoperative hypertension status, and anesthesia method. Multiple logistic regression analysis with these factors revealed that the surgical site (unilateral/bilateral, p = 0.024) and anesthesia method (p = 0.039) were significant factors for the occurrence of postoperative DVT after TKA. Conclusions Patients undergoing simultaneous bilateral TKAs and patients undergoing TKA with general anesthesia need more attention regarding DVT even with chemoprophylaxis using LMWH after TKA.

Efficacy and safety of salvianolate and enoxaparin in the prevention of perioperative deep venous thrombosis in gastrointestinal surgery

“…21,22 However, LMWH also has risk of spontaneous bleeding and DVT after surgery. 23,24 Salvianolate is extracted from the Traditional Chinese medicine Salvia miltiorrhiza, which is milder than heparin and other anticoagulants. 10,12 It is safe to prevent DVT during perioperative period without bleeding tendency and widely used in perioperative period in China.…”

“…Low molecular weight heparin anticoagulation is an effective method to prevent DVT, which can reduce the risk of lower extremity DVT 21,22 . However, LMWH also has risk of spontaneous bleeding and DVT after surgery 23,24 …”

Central Sensitization and Neuropathic Pain Cumulatively Affect Patients Reporting Inferior Outcomes Following Total Knee Arthroplasty

“…First, most of the patients in each group were women (88% overall; 279 of 316). The reason for this is unknown, but female predominance has been reported in the Korean population undergoing TKA [50][51][52][53][54] . It is also known that the prevalences of central sensitization and neuropathic pain are higher in women 14,55 .…”

Low muscle mass is an independent risk factor for postoperative blood transfusion in total knee arthroplasty: a retrospective, propensity score-matched cohort study

“…Despite its benefits, TKA involves substantial blood loss and approximately one-third of patients receive postoperative transfusions [ 6 , 7 ]. Allogeneic transfusion is necessary for hemodynamic stability, but has side effects such as an increased risk of deep vein thrombosis, deep surgical site infection, and mortality, which adversely affect patient outcomes [ 8 – 12 ].…”