Recent Korean Perspective of Deep Vein Thrombosis After Total Knee Arthroplasty

Prevalence of Deep Vein Thrombosis and Pulmonary Embolism Treated with Mechanical Compression Device After Total Knee Arthroplasty in Asian Patients

“…First, there were no direct comparison of patients treated with pharmacological methods. Second, the number of patients is relatively small [4][5][6][7][8]. Third, this study is not a randomized study.…”

“…Conversely, patients with abnormally low antithrombin III levels, heterozygosity for the prothrombin promotor G20210A mutation, or both had a 100% chance of developing PE. Kim et al [4] reported that the absence of thrombophilic polymorphisms, particularly factor V Leiden mutation, antithrombin III deficiency, and prothrombin promoter G20210A mutation, signaled a low incidence of DVT and PE, especially when combined with low clinical prothrombotic risk factors (obesity, prolonged immobilization, venous diseases, hyperlipidemia, etc.). Our study confirmed their findings [6][7][8]17,19,21,23].…”

“…Although the prevailing opinion is that patients with a proximal thrombus should be treated with anticoagulants, our study has shown that all thrombi, regardless of their site or size, resolved A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT 11 completely and spontaneously without treatment with anticoagulants and without causing PE. The decision was made not use anticoagulation on any of these patients on the basis of: no patient had history of DVT before the TKA; all patients had low comorbidity; all patients were mobilized 2 nd day after the operation; they were active and no patient had morbid obesity: Furthermore, on the basis of findings of previous studies [4][5][6][7][8]16,17]. One caveat is that complete thrombi in external iliac vein may be an indication for treatment with anticoagulation.…”

“…Several reports have suggested that there is a strikingly low prevalence of DVT [3][4][5] and PE after TKA in Asian patients which may be attributed to differences in genetic and dietary backgrounds.…”

Incidences of Deep Vein Thrombosis and Pulmonary Embolism after Total Knee Arthroplasty Using a Mechanical Compression Device with and without Low-Molecular-Weight Heparin

“…Some reports have described a low prevalence of DVT and PE after TKA in Asian patients compared with western populations121314). It is generally believed that the rate of VTE is low in Asia, so prophylaxis is seldom used15).…”