TITLE:
Correlation of Preoperative D-Dimer Levels and Postoperative Venous Thromboembolism in Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty
AUTHORS:
Sanjay Agarwala, Mayank Vijayvargiya, Neeraj Mishra
KEYWORDS:
Plasma D-Dimer, DVT, Colour Doppler, Clinical DVT, Preoperative D-Dimer, TKA, THA, Early DVT
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.9,
September
18,
2021
ABSTRACT: Background: The relationship of
preoperative D-dimer and Venous thromboembolism (VTE) after total knee
arthroplasty (TKA) and total hip arthroplasty (THA) remains controversial. The
purpose of this study was to assess the value of D-dimer in the detection of
early VTE after TKA and THA. Materials and Methods: A total of 312
patients were evaluated in this retrospective study from 2016 to 2020 at a
tertiary care centre, Mumbai who were operated for THA and TKA. The measurement
of plasma D-dimer level was done preoperatively and clinically symptomatic
patients were evaluated and confirmed for VTE by Colour Doppler Sonography. The
plasma D-dimer levels were correlated statistically with the sonographic VTE. Results: 11 patients developed Deep Vein Thrombosis
(DVT) and 1 patient developed Pulmonary embolism (PE). Preoperative
plasma D-dimer levels were significantly higher (P (pelvic and femoral veins), and 2 thrombi were seen in distal veins
(posterior tibial, peroneal, gastrocnemian veins) of the calf in THA patients,
and all 8 thrombi were seen in the distal veins (posterior tibial, peroneal,
gastrocnemian veins) of the calf in TKA patients. Conclusion: We infer
that if the preoperative D-dimer levels were more than 0.5 mg/l, the chances of developing VTE postoperatively are more, which can be diagnosed clinically and further by other
investigations. In this study, we have shown that doing preoperative D-dimer
level can almost PREDICT the development of VTE and thus prevent complications.