Original Research
Venous Hemodynamic Alterations in Lower Limbs Undergoing Total Joint Arthroplasty
Am J Orthop. 2009 August;38(8):E137-E140
Author and Disclosure Information
Kousuke Sasaki, MD, Hiromasa Miura, MD, PhD, Shinichiro Takasugi, MD, PhD, Seiya Jingushi, MD, PhD, Eiji Suenaga, MD, PhD, and Yukihide Iwamoto, MD, PhD
Dr. Sasaki is Orthopaedic Surgeon, Dr. Miura is Associate Professor, Dr. Takasugi is Instructor, Dr. Jingushi is Associate Professor, Dr. Suenaga is Orthopaedic Surgeon, and Dr. Iwamoto is Professor, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Using duplex ultrasonography, we measured preoperative and postoperative venous flow volume in 32 operated lower limbs without deep vein thrombosis (DVT) after total hip arthroplasty (THA, n = 17) and total knee arthroplasty (TKA, n = 15). We also calculated percentage decrease in mean venous flow volume (MVFV) from before surgery to after surgery. Patients with a history of one of several venous diseases, congestive heart failure, or morbid obesity were excluded.
In both groups (THA, TKA), MVFV 3 days after surgery and MVFV 1 week after surgery were significantly lower than preoperative MVFV, but MVFV at 2 or more weeks after surgery did not differ significantly from preoperative MVFV (result 1). Incidentally, the decrease in MVFV in the lower limbs was significantly larger 3 days after TKA than 3 days after THA (result 2).
As venous stasis has a central role in thrombus formation, result 1 suggests that the risk for DVT initiation is low at 2 or more weeks after THA and TKA in patients with normal preoperative venous physiologic functions. Result 2 is probably correlated with the evidence that DVT incidence is higher after TKA than after THA.