Lower Extremities’ Postthrombotic Syndrome after Total Knee Arthroplasty
Saradej Khuangsirikul MD*, Sudsriluk Sampatchalit MD**, Trakool Foojareonyos MD*, Thanainit Chotanaphuti MD*
Affiliation : * Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand ** Department of Radiology, Phramongkutklao Hospital, Bangkok, Thailand
Background : Deep venous thrombosis (DVT) is a disease associated with high morbidity in 40-60% patients
who underwent Total Knee Arthroplasty (TKA). Postthrombotic syndrome (PTS) is a common long-term
complication that may develop within 6 months or more than 2 years after episode of DVT.
Objective : To examine the prevalence of PTS in patients who had history of previous DVT and non-previous
DVT at least 2-year follow-up period after TKA.
Material and Method: Retrospective chart review was done. All patients who underwent TKA during October
2002-2005 were included. They were postoperatively assessed for PTS with Villalta score and duplex
ultrasonography at > 2 years. The confirmed diagnosis of DVT was done by contrast venography.
Results : 22 of 76 patients (56 previous DVT, 20 non-previous DVT) had PTS based on the clinical assessment.
The previous-DVT group had significantly higher risk to PTS (OR= 1.59; 95% CI: 1.294-1.949; p-value =
0.001). When diagnosed with duplex ultrasonography, 36 in 56 patients of previous-DVT group and 8 in 20 of
non-previous-DVT group were found positive venous reflux. Most of venous reflux occurred at popliteal vein
(77%) and posterior tibial vein (59%).
Conclusion : After TKA, the patients who developed DVT had higher risk to PTS (OR = 1.588). Treatment of
DVT may not decrease this risk. Prevention of DVT becomes an important approach to prevent PTS.
Keywords : Postthrombotic syndrome, Deep venous thrombosis, Total knee arthroplasty
