Venous Thromboembolism Prevention Protocol: Experience of 2,000 Cases in Total Knee Arthroplasty*Artikel in mehreren Sprachen: português | English
Objective The objective of the present study is to evaluate the impact evaluate the impact of an institutional protocol on a tertiary hospital for the prevention of venous thromboembolism in 2005 patients submitted to primary total knee arthroplasty (TKA).
Methods Data from medical records of patients submitted TKA before (n = 1,115) and after (n = 890) the implementation of the institutional protocol, totaling 2,005 patients, were retrospectively reported. Demographics, comorbidities, and outcomes were analyzed.
Results There was no significant change in the cases of deep venous thrombosis (DVT) (1.6% versus 2.4%; p = 0.211). There was an increase in cases of pulmonary embolism (PE) (0.2% versus 0.8% p = 0.049).
Conclusion Despite the implementation of the prevention protocol, no reduction in the studied events was observed. The small global incidence makes further studies with larger series necessary to confirm or rule out these findings.
Work conducted at the Hospital Madre Teresa, Belo Horizonte, state of Minas Gerais, Brazil.
Eingereicht: 30. Dezember 2018
Angenommen: 18. Juli 2019
13. Dezember 2019 (online)
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil
- 1 HCPUnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality. Disponível em: http://hcupnet.ahrq.gov
- 2 Ethgen O, Bruyère O, Richy F. , et al. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 2004; 86 (05) 963-974
- 3 Khokhar A, Chari A, Murray D. , et al. Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective. Knee 2013; 20 (03) 170-176
- 4 Chandrasekaran S, Ariaretnam SK, Tsung J. , et al. Early mobilization after total knee replacement reduces the incidence of deep venous thrombosis. ANZ J Surg 2009; 79 (7-8): 526-529
- 5 Anderson DR, Dunbar M, Murnaghan J. , et al. Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty. N Engl J Med 2018; 378 (08) 699-707
- 6 Kjaersgaard-Andersen P, Kehlet H. Should deep venous thrombosis prophylaxis be used in fast-track hip and knee replacement?. Acta Orthop 2012; 83 (02) 105-106
- 7 O'Reilly RF, Burgess IA, Zicat B. The prevalence of venous thromboembolism after hip and knee replacement surgery. Med J Aust 2005; 182 (04) 154-159
- 8 Song K, Xu Z, Rong Z. , et al. The incidence of venous thromboembolism following total knee arthroplasty: a prospective study by using computed tomographic pulmonary angiography in combination with bilateral lower limb venography. Blood Coagul Fibrinolysis 2016; 27 (03) 266-269
- 9 Quinlan DJ, Eikelboom JW, Dahl OE. , et al. Association between asymptomatic deep vein thrombosis detected by venography and symptomatic venous thromboembolism in patients undergoing elective hip or knee surgery. J Thromb Haemost 2007; 5 (07) 1438-1443
- 10 Howie C, Hughes H, Watts AC. Venous thromboembolism associated with hip and knee replacement over a ten-year period: a population-based study. J Bone Joint Surg Br 2005; 87 (12) 1675-1680
- 11 Zhang ZH, Shen B, Yang J. , et al. Risk factors for venous thromboembolism of total hip arthroplasty and total knee arthroplasty: a systematic review of evidences in ten years. BMC Musculoskelet Disord 2015; 16: 24
- 12 Azboy I, Barrack R, Thomas AM. , et al. Aspirin and the prevention of venous thromboembolism following total joint arthroplasty: commonly asked questions. Bone Joint J 2017; 99-B (11) 1420-1430
- 13 Chung LH, Chen WM, Chen CF. , et al. Deep vein thrombosis after total knee arthroplasty in asian patients without prophylactic anticoagulation. Orthopedics 2011; 34 (01) 15