American Society of Hirudotherapy

Deep vein thrombosis after total knee replacement

Research article published in Annals of the Academy of Medicine, Singapore (2000)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsRuban P et al. · 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.

Publication typeJournal ArticleResearch Support, Non-U.S. Gov't
Indexed MeSH termsAdultAge DistributionAgedAged, 80 and overArthroplasty, Replacement, KneeBody WeightCase-Control StudiesFemaleHospitals, GeneralHumansIncidenceMale

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This prospective cohort of 100 consecutive total-knee-replacement patients in Singapore, who received no prophylaxis and were screened by duplex scan on day 7, found an overall deep-vein-thrombosis incidence of 14% (mostly distal, with one pulmonary embolism), substantially lower than the 46-84% figures cited in Western literature, and identified no risk factor that significantly distinguished those who developed DVT. For hirudotherapy the link is indirect and epidemiological: it documents the burden of venous thromboembolism after major orthopedic surgery, the antithrombotic problem space that leech-derived thrombin inhibitors such as hirudin/lepirudin have been investigated to address. The caveat is important: this single-center observational study evaluated DVT epidemiology and screening, not any leech-based or pharmacologic intervention, so it provides background context only and no evidence about hirudotherapy efficacy or safety.

Citation

Deep vein thrombosis after total knee replacement.

Ruban P et al. · Annals of the Academy of Medicine, Singapore, 2000

DOIPubMed

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