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Are current thrombo-embolic prophylaxis guidelines applicable to unicompartmental knee replacement?
C A Willis-Owen1, K M Sarraf, A E Martin
1Queen Mary's Hospital, Department of Orthopaedic Surgery, Frognal Avenue, Sidcup, Kent DA14 6LT, UK. cawillisowen@gmail.com
The Journal of Bone and Joint Surgery. British Volume
|December 14, 2011
Summary
Deep-vein thrombosis (DVT) risk is significantly lower after unicompartmental knee replacement (UKR) compared to total knee replacement (TKR). Current national prophylaxis guidelines for TKR may not be suitable for UKR patients.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
- Thrombosis Research
Background:
- Deep-vein thrombosis (DVT) is a frequent complication following knee replacement surgery.
- Current thromboprophylaxis guidelines are based on total knee replacement (TKR) data, with no specific recommendations for unicompartmental knee replacement (UKR).
Purpose of the Study:
- To compare the incidence of DVT between TKR and UKR.
- To evaluate the applicability of existing national DVT prophylaxis guidelines for UKR procedures.
Main Methods:
- Prospective data collection on 3449 knee replacement surgeries.
- Analysis of variables including procedure type, tourniquet time, surgeon, patient age, drain use, and gender.
- Correlation of these variables with the incidence of symptomatic DVT.
Main Results:
- The overall DVT rate was 1.6%.
- Total knee replacement (TKR) showed a significantly higher DVT incidence (2.2%) compared to unicompartmental knee replacement (UKR) (0.3%) (p < 0.001).
- Operation type was the only variable significantly associated with DVT incidence.
Conclusions:
- Unicompartmental knee replacement (UKR) has a substantially lower incidence of DVT than total knee replacement (TKR).
- The risk-benefit profile for DVT prophylaxis established for TKR may not directly apply to UKR.
- Further research is needed to determine optimal thromboprophylaxis strategies for UKR.
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