Key result
In Korean patients undergoing unicompartmental knee arthroplasty without thromboprophylaxis, asymptomatic venous thromboembolism occurred in 26% of patients, but all lesions completely resolved spontaneously within 6 months.
Why the study?
Does the omission of routine thromboprophylaxis lead to clinically significant venous thromboembolism in Korean patients undergoing unicompartmental knee arthroplasty?
Cohort (n=70)
No
Does the omission of routine thromboprophylaxis lead to clinically significant venous thromboembolism in Korean patients undergoing unicompartmental knee arthroplasty?
Routine thromboprophylaxis may not be necessary in Korean patients undergoing unicompartmental knee arthroplasty, as postoperative VTEs, while frequent, appear to be asymptomatic and resolve spontaneously.
Frequent asymptomatic VTE after UKA without prophylaxis resolved spontaneously; leaves open whether routine thromboprophylaxis can be omitted.
This study was undertaken to determine the prevalence and the natural course of venous thromboembolism (VTE) without thromboprophylaxis to ascertain whether routine thromboprophylaxis is necessary following unicompartmental knee arthroplasty (UKA) in Korean patients. The medical records and multidetector row computed tomography (MDCT) imaging of the consecutive 77 UKAs in 70 patients were reviewed. In all patients, MDCTs were undertaken preoperatively and at 1-week after surgery, and VTE symptoms were evaluated. At postoperative 6-months, follow-up MDCTs were undertaken in all patients in whom VTEs were newly detected after surgery. VTE lesions were newly detected in 18 (26%) of the 70 patients. However, none of the patients complained of VTE-related symptoms and MDCT demonstrated that all VTEs were small and involved limited portion without lower leg edema or pleuroparenchymal complication. At the 6-month follow up MDCT, all types of VTEs were shown to be completely resolved, regardless of their location. All of the VTE lesions maintained an asymptomatic status for 6-month after surgery. VTE following UKA in Korean patients who do not receive thromboprophylaxis seems to occur frequently, but all of the VTEs are clinically insignificant and all VTEs are spontaneously regressed. Routine thromboprophylaxis or thrombolytic treatment in Korean patients undergoing UKA may not be necessary.
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Koh et al. (2016) conducted a cohort in Unicompartmental knee arthroplasty (n=70). No thromboprophylaxis was evaluated on Prevalence of venous thromboembolism (VTE). In Korean patients undergoing unicompartmental knee arthroplasty without thromboprophylaxis, asymptomatic venous thromboembolism occurred in 26% of patients, but all lesions completely resolved spontaneously within 6 months.
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