[Lower limb varicosity in patients, with indication for total knee arthroplasty]

Area of Science:

• Vascular Surgery
• Orthopedic Surgery
• Thrombosis Research

Context:

• Peripheral venous pathology, specifically varicose veins, is a common comorbidity in patients undergoing total knee arthroplasty (TKA).
• The presence of untreated venous disease may increase the risk of postoperative complications, particularly deep venous thrombosis (DVT).
• Evaluating the impact of preoperative venous treatment on TKA outcomes is crucial for patient safety and surgical success.

Purpose:

• To investigate the necessity and efficacy of preoperative treatment for peripheral venous pathology in patients indicated for TKA.
• To determine if addressing varicose veins prior to TKA reduces the incidence of postoperative deep venous thrombosis (DVT) and other complications.
• To establish guidelines for managing venous insufficiency in patients undergoing major orthopedic procedures.

Summary:

• A study evaluated 110 patients for TKA, with 35 having lower limb varicose veins. Of these, 31 were treated preoperatively using surgical, pharmacological, or mechanical methods, while one patient did not receive treatment.
• Total knee arthroplasty was performed 8-12 weeks post-venous treatment, with DVT prophylaxis in all cases.
• Outcomes showed a low incidence of DVT and pulmonary embolism (2 cases and 1 case, respectively) in the preoperatively treated group. The untreated patient developed DVT and chronic edema, highlighting the importance of preoperative intervention.

Impact:

• Preoperative treatment of varicose veins is essential for successful total knee arthroplasty (TKA).
• Managing peripheral venous pathology proactively reduces the risk of serious postoperative complications like deep venous thrombosis (DVT) and pulmonary embolism.
• This approach improves patient outcomes and contributes to the overall success of knee replacement surgery.