Related Experiment Video
Updated: Apr 12, 2026

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
D-dimer testing cannot rule out thromboembolism after major lower extremity arthroplasties and thromboprophylaxis
Etsuko Sugimoto1, Takayuki Kuroda2, Yoshihisa Fujita3
1Departments of Anestheisology and ICM, Kawasaki Medical School, 577 Matsushima, Kurashiki-City, Okayama, 701-0192, Japan.
Purpose:
Our previous study showed, for the first time, that a guideline-recommended thromboprophylactic strategy reduced the prevalence of venous thromboembolism (VTE) including venous thromboembolism and pulmonary embolism after arthroplasties of the major lower extremities, such as total hip arthroplasty (THA) or total or partial knee arthroplasty (TPKA), to 4.4 %. In this retrospective study, we examined the diagnostic value of D-dimer for VTE and try to confirm the low prevalence of VTE after THA or TPKA.
Methods:
This was a retrospective study including 380 procedures of 361 patients who underwent elective 129 TPKA or 251 THA, as well as multidetector computed tomography (MDCT) on postoperative day 7 with D-timer testing to screen for VTE. In 303 of 380 procedures, D-timer testing was performed on the same day as MDCT. The antithrombotic prophylaxes included medical and mechanical therapy and early ambulation.
Results:
The prevalence of VTE was 4.5 % (17 cases) (95 % confidence interval 2.4-6.6 %). The D-dimer level was significantly greater in patients with VTE than in those without (13.4 ± 11.1 vs 10.1 ± 6.5 μg/mL). At the lowest cut-off value of 4.0 μg/mL, D-dimer testing ruled out VTE in only 26 of 303 cases with 1 (6 %) false negative result.
Conclusions:
The low incidence of postoperative VTE with the strict anticoagulation strategy was confirmed in this validation study. D-dimer testing is not useful for excluding VTE postoperatively in patients who undergo THA or TPKA.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Pulmonary Embolism III: Nursing Management
Anticoagulant Drugs: Low-Molecular-Weight Heparins

