BackgroundWe sought to document the incidences of deep vein thrombosis (DVT) before and after total knee arthroplasty (TKA). In addition, we aimed to explor whether routine preoperative DVT evaluation was useful to establish DVT treatment strategies after TKA. Finally, we wanted to evaluate whether the incidences of DVT differed between patients undergoing unilateral and staged bilateral TKA within the same hospitalization period.MethodsThe retrospective study included 153 consecutive patients (253 knees) with osteoarthritis who underwent primary TKA. After surgery, mechanical compression devices (only) were used for DVT prophylaxis. DVT status before and after TKA was determined via 128-row, multidetector, computed tomography/indirect venography.ResultsOverall, the preoperative DVT incidence was 2.6% per patient and 1.6% per knee. All preoperative DVTs were distal in nature and asymptomatic. After TKA, newly developed thrombi were evident in various calf veins, without propagation of any pre-existing thrombi. Postoperatively, the overall incidences of DVT were 69.9% per patient and 58.5% per knee. The DVT incidences were 66% per patient and 69.8% per knee in the unilateral TKA group. In contrast, the incidences were 72% per patient and 55.5% per knee in the staged bilateral TKA group. There was one case of symptomatic distal (unilateral TKA; 0.65% per patient and 0.4% per knee) and proximal DVT (bilateral TKA; 0.65% per patient and 0.4% per knee), respectively.ConclusionsThe incidence of symptomatic DVT was low in Asian patients treated with mechanical compression devices alone, although substantial portion of patients had DVT after surgery. Routine preoperative DVT evaluation is probably not necessary; preoperative DVT was rare and of limited clinical relevance. Furthermore, staged bilateral TKA during a single period of hospitalization does not increase the incidence of DVT.
Accessory bones and tarsal coalitions are the most common developmental variations in the foot and ankle. Accessory bones are usually derived from unfused primary or secondary ossification centers and may exist adjacent to the main bone where they are separated. 1) Tarsal coalitions are abnormal connections of two or more tarsal bones and are regarded as the results of impaired mesenchymal separation of the tarsal bones. 2,3) They can be divided into os-seous (synostosis), fibrous (syndesmosis), or cartilaginous (synchondrosis) connections. 4) Although accessory bones and tarsal coalitions may be present at birth, individuals with accessory bones or tarsal coalitions can be asymptomatic; therefore, these might not be noticed until an incidental radiographic examination reveals their presence. However, some conditions, such as talocalcaneal coalition, calcaneonavicular coalition, os subfibulare, os trigonum, and os naviculare, can cause pain around the foot and ankle and require clinical interventions. Symphalangism of the toe, also known as the biphalangeal toe, is an uncommon condition characterized by fusion of interphalangeal joints. Toe symphalangism has been evaluated in several studies and has been shown as the most common variant resulting from incomplete segmentation rather than pha
High tibial osteotomy (HTO) is a well-established treatment for medial compartment knee osteoarthritis (OA), which shifts the weight-bearing axis from the medial to the lateral side of the knee. As the adjacent ankle joint may be directly affected by the change in biomechanics, this study aimed to evaluate the change in the intersegmental foot and ankle motion after HTO in patients with genu varum. The study SUPPORTING INFORMATION
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