Deep-vein thrombosis and continuous passive motion after total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Vascular Medicine
• Physical Therapy

Background:

• Total knee arthroplasty (TKA) is a common orthopedic procedure.
• Deep vein thrombosis (DVT) is a potential complication following TKA.
• The efficacy of continuous passive motion (CPM) in preventing DVT post-TKA is debated.

Purpose of the Study:

• To investigate the effectiveness of continuous passive motion (CPM) combined with routine physiotherapy in preventing deep vein thrombosis (DVT) after total knee arthroplasty (TKA).
• To identify risk factors associated with DVT development in TKA patients.

Main Methods:

• A randomized controlled trial involving 150 patients undergoing TKA.
• Group 1 received routine physiotherapy.
• Group 2 received routine physiotherapy plus CPM of the operated lower limb.
• DVT incidence and location were assessed using radiography.
• Patient demographics and surgical factors were analyzed for DVT association.

Main Results:

• No pulmonary emboli were observed in either group.
• Approximately 40% of patients in both groups developed calf vein thrombosis, irrespective of CPM.
• Deep vein thrombosis extended proximally in 5% of patients in both groups.
• Cemented fixation of TKA components was associated with a higher incidence of DVT.
• Patient factors like sex, age, obesity, hypertension, and diabetes did not significantly influence DVT rates.

Conclusions:

• Continuous passive motion (CPM) does not appear to reduce the incidence of calf vein thrombosis following total knee arthroplasty (TKA).
• Cemented fixation for TKA components is a significant risk factor for developing deep vein thrombosis (DVT).
• Further research may be warranted to explore alternative DVT prophylaxis strategies in TKA patients, particularly those with cemented fixation.