Effect on Deep Venous Thrombosis with Flexion during Total Knee Arthroplasty

HSS Journal


Thomas P. Sculco, MD

Thomas P. Sculco, MD

Attending Orthopedic Surgeon, Hospital for Special Surgery
Surgeon-in-Chief Emeritus, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

Geoffrey H. Westrich, MD

Geoffrey H. Westrich, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Research Director of Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery
Assistant Scientist, Hospital for Special Surgery
Co-Chairman, Complex Case Review Panel, Hospital for Special Surgery
Associate Professor of Clinical Orthopedic Surgery, Weill Cornell Medical College

Raz Winiarsky, MD
Hospital for Special Surgery

Michael Betsy, BA
Dartmouth Medical School, Hanover, NH

Lena Maun, BA
Hospital for Special Surgery

Abstract:
This study investigates the relationship between intraoperative extreme flexion and tibia-femoral dislocation during total knee arthroplasty on the prevalence of postoperative deep venous thrombosis. Knees were randomized into two groups. The control group underwent the procedure according to normal protocol, which kept the knee in extreme flexion and maintained dislocation for the duration of the exposure, whereas the variable group underwent the procedure modified to minimize the total amount of time the knee was hyperflexed and dislocated. Venograms were positive in 42% (39/92) of the control knees and 38% (30/79) of the modified group (p = 0.6). Proximal deep venous thrombosis were found in 12% (11/92) of the control knees and in 16% (13/79) of the modified knees (p = 0.4). No statistical difference could be detected between the two techniques in regards to the incidence of deep venous thrombosis.

This article appears in HSS Journal: Volume 2, Number 2.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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