The Incidence of Deep Vein Thrombosis and Pulmonary Embolism after Total Knee Arthroplasty: The Screening Study by Radionuclide Venography
Chathchai Pookarnjanamorakot MD*, Rojana Sirisriro MD**, Charindr Eurvilaichit MD**, Suphaneewan Jaovisidha MD**, Isara Koysombatolan MD*
Affiliation : * Department of Orthopaedics, Ramathibodi Hospital, Mahidol University ** Department of Radiology, Ramathibodi Hospital, Mahidol University
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are considered uncommon in Asian
populations and thrombo-prophylaxis is rarely indicated. The objective of this study was to investigate the
incidence of DVT and PE after total knee replacement in an Asian population.
Materials and Methods : There were 100 patients who underwent total knee replacement enrolled in this
study. No thrombo-prophylaxis was given to these patients. The possible risk factors such as age, sex, body
mass index (BMI), operative time and the post-operative blood loss were recorded.
Results : The duplex ultrasonography (controlled) showed no evidence of DVT in all cases. There were 67
patients who completed radionuclide venography in this study. The incidence of DVT from positive
radionuclide venography was 24% (16/67 patients) and PE was 12% (8/67 patients). All patients with
positive imaging studies were asymptomatic. The risk factors were similar in both groups.
Conclusion : The incidence of DVT and PE in post-operative total knee replacement surgery, although lower
than the incidence in Western populations, is higher than previously assumed. The radionuclide venography
is less invasive and a useful diagnostic method for both DVT and PE. Because all patients with DVT and PE
are asymptomatic, the use of thrombo-prophylaxis should be considered for risk and benefit.
Keywords : Deep vein thrombosis, Pulmonary embolism, Venoscintigraphy, Asian population
