Duration of Anesthesia and Venous Thromboembolism After Hip and Knee Arthroplasty

The incidence of pulmonary embolism and deep vein thrombosis and their predictive risk factors after lower extremity arthroplasty: a retrospective analysis based on diagnosis using multidetector CT

“…First, CTA-CTV was limited to one use on postoperative day 7. A prospective study of 70 patients using repeated ultrasonography revealed that DVT occurs mostly in the first two weeks after THP [8,16]. Thus, the true incidence of asymptomatic VTE may be slightly higher than what we observed in our patients.…”

“…Obesity may have delayed the postoperative recovery in patients with lower extremity arthroplasty, resulting in venous stasis and DVT formation. Another case-control study of patients with lower extremity arthroplasty [8] showed an association between the duration of anesthesia and the incidence of postoperative VTE but found that other variables, such as type of anesthesia and laboratory data, do not predict VTE. The results of the current study confirmed their findings regarding anesthesia type and laboratory data.…”

“…In addition, we sought to define the predictive risk factors for VTE. Previous studies have shown that several factors are associated with symptomatic VTE after THA or TPKA, including obesity, duration of surgery, poor physical status [7], anesthesia duration [3.5 h, absence of antithrombotic prophylaxis, and revision arthroplasty [8]. Risk factors for the overall incidence of VTE confirmed by CTA-CTV, irrespective of VTE symptoms, are not known.…”

Reducing Blood Loss in Bilateral Total Knee Arthroplasty with Patient-Specific Instrumentation

“…This process starts early during surgery with venous stasis caused by tourniquet use and vessel torsion with high flexion of the knee. Prolonged anesthetic and operative time have been shown to significantly increase the risk of thrombotic events, 23 and, therefore, the thromboembolic risk may be higher for simultaneous bilateral TKA. In 1 study, the rate of venous thromboembolism was 10.9% in simultaneous bilateral TKA versus 3.1% in unilateral procedures.…”

Risk of venous thromboembolism after total hip and knee replacement in older adults with comorbidity and co-occurring comorbidities in the Nationwide Inpatient Sample (2003-2006)

“…Similarly the association of COPD may be explained through an immobility or stasis mechanism. Newer evidence, in both surgical [6,7,9,10] and non-surgical settings [12], suggests that atherosclerotic conditions such as coronary artery disease (CAD) and cerebrovascular disease (CVD) are also associated with an increased risk of VTE. In general, these studies had a small number of observations and/or did not focus on discrete surgical procedures, making it difficult to draw conclusions about modest but clinically important effects on VTE of comorbidities for individual surgeries.…”