The Outcome Of Muscular Vein Thrombosis After Total Knee Arthroplasty

Objective To observe the outcome of muscular vein thrombosis after joint arthroplasty and to analyze potential factors that could affect the result.Methods From June 2019 to October 2019,a total of 64 fresh muscular vein thrombosis diagnosed by ultrasound were collected during hospitalization.There were 29 male and 35 female with the average age of 56.3 ± 7.7 years old(46-82 years old).Sonography was used to evaluate the resolution of muscular vein thrombosis at the time point of 2 and 6weeks and 3 months postoperatively and the results were compared between the three time points.Multivariable analysis was performed to evaluate the relationship between the resolution of DVT 3 months postoperatively and risk factors including age(>65/≤65 years old),Body Mass Index(> 25 / ≤ 25 kg/m2),gender(male / female),maximum diameter(> 0.7 /≤ 0.7 cm),duration of anticoagulation therapy(extended anticoagulation therapy after discharge/anticoagulation therapy during hospitalization).Results At 2 weeks postoperatively,64 cases(34 left and 30 right,χ2 = 0.059,P = 0.807)of muscular vein thrombosis were found resolving with 13 cases(20.3%)thoroughly resolved and 37 cases(57.8%)partly resolved,only 2 case(3.1%)progressed but not into the popliteal veins,12 cases(18.8%)had no change on the size.At 6 weeks postoperatively,33cases(51.6%)thoroughly resolved and 27 cases(42.2%)partly resolved,no thrombosis progressed,4 cases(6.3%)had no change on the size.At the follow up of 3 months,55 cases(85.9%)through resolved and 9 cases(14.1%)partly resolved,no case progressed into proximal veins,and no case had no change on the size.No severe complications of pulmonary embolism(PE),post-thromboembolic syndrome and major hemorrhage were found in all patients within 3 months.There was no significant difference in age,sex and body mass index among different time periods of muscular venous thrombosis(2 weeks,6 weeks and3 months)(P > 0.05).The mode of anesthesia,use of a pneumatic tourniquet and the maximum diameter of thrombus were independent factors affecting the outcome of muscular venous thrombosis.Conclusion The outcome of muscular venous thrombosis in perioperative period of TKA tends to disappear naturally.The application of tourniquet,the mode of anesthesia and the maximum diameter of thrombus has a significant effect on the natural course of muscular vein thrombosis.