Deep vein thrombosis after total knee replacement
Research article published in Annals of the Academy of Medicine, Singapore (2000)
Abstract
INTRODUCTION: The prevalence of deep vein thrombosis after total knee replacement has been quoted to be between 46% and 84% in the Western literature. The aims of this study were to determine its prevalence in the Singapore population and to assess the need for prophylaxis against deep vein thrombosis. MATERIALS AND METHODS: We examined data on 100 consecutive patients undergoing total knee replacement at the Adult Reconstructive Service, Department of Orthopaedic Surgery, Singapore General Hospital and assessed the possible risk factors: age, sex, weight, previous surgery, unilateral or bilateral surgery, postoperative rehabilitation, tourniquet and operating time. Functional and knee scores based on the Knee Society Clinical Rating System were also assessed. No prophylaxis was given to these patients. These patients underwent a duplex scan of both lower limbs on the seventh postoperative day. Treatment was instituted only if proximal deep vein thrombosis was detected. RESULTS: The overall incidence of deep vein thrombosis was 14% with 64.3% of it occurring distally. Deep vein thrombosis was more common in bilateral total knee replacement (22.2%) compared to unilateral total knee replacement (13.2%). Partial thrombosis was present in 71.4% and occurred predominantly in the ipsilateral leg. There was no evidence of propagation. Only 1 patient developed pulmonary embolism and was treated successfully but there was no evidence of deep vein thrombosis on duplex scan in this patient. CONCLUSION: There was no significant difference in the risk factors between patients who did and those who did not develop deep vein thrombosis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Warum dies für die Hirudotherapie relevant ist
Diese prospektive Kohorte aus 100 aufeinanderfolgenden Patienten mit Knietotalendoprothese in Singapur, die keine Prophylaxe erhielten und am Tag 7 mittels Duplexsonographie untersucht wurden, ergab eine Gesamtinzidenz tiefer Venenthrombosen von 14% (überwiegend distal, mit einer Lungenembolie), was deutlich unter den in der westlichen Literatur genannten Werten von 46–84% liegt, und identifizierte keinen Risikofaktor, der jene, die eine TVT entwickelten, signifikant unterschied. Für die Hirudotherapie ist der Bezug indirekt und epidemiologisch: Sie dokumentiert die Last der venösen Thromboembolie nach großen orthopädischen Eingriffen — jenen antithrombotischen Problembereich, zu dessen Behandlung aus dem Blutegel gewonnene Thrombininhibitoren wie hirudin/lepirudin untersucht wurden. Der Vorbehalt ist wichtig: Diese monozentrische Beobachtungsstudie untersuchte die Epidemiologie und das Screening der TVT, nicht irgendeine blutegelbasierte oder pharmakologische Intervention, sodass sie lediglich Hintergrundkontext liefert und keine Evidenz zur Wirksamkeit oder Sicherheit der Hirudotherapie.
Zitation
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