FREQUENCY OF DVT AFTER TOTAL KNEE REPLACEMENT IN PAKISTANI POPULATION BY EMPLOYING COLOR DUPLEX SCAN

Frequency of DVT after Total Knee Replacement

Abstract

Objective: To determine the frequency of Deep Vein Thrombosis (DVT) by Color Duplex Scanning (CDS) after total knee replacement (TKR) in Pakistani population.
Study design: Interventional study.
Place and duration of study: Department of Orthopaedic Surgery, Combined Military Hospital Lahore, from 1st Sep 2007 to 1st Sep 2008.
Patients and Methods: Thirty five patients, both male and female, age 50 to 80 years, ASA physical status II and III scheduled for total knee replacement (TKR) were subjected to preoperative and postoperative color Doppler to determine the presence of asymptomatic DVT in both legs. None of the patients were administered anticoagulant.
Results: DVT was not detected in any case after TKR. One patient developed nonfatal pulmonary embolism on 10th postoperative day. CDS did not pick DVT in this patient.
Conclusion: CDS is a useful investigation tool to determine the presence of DVT in total knee replacements surgery. In the West all patients undergoing TKR are administered anticoagulant therapy. This practice is however, not universally accepted in Pakistan. Few studies conducted in Pakistan are equivocal. Present study was done to detect asymptomatic DVT in our patients after TKR. Our study does not show any evidence of DVT as picked up by CDS. The difference could be due to racial factor or the sample size was too small or the yield of CDS may not be very high.
Key words: DVT, TKR, Color Duplex Scan, Anticoagulant therapy.