Treatment for Proximal Deep Vein Thrombosis after Total Knee Arthroplasty

Abstract

Unlike distal deep vein thrombosis, proximal deep vein thrombosis carries a high risk of pulmonary embolism. Of 595 consecutive patients undergoing total knee arthroplasty between August 2007 and July 2009, proximal deep vein thrombosis was identified in three (0.5%) using venous compression ultrasonography. The patients were all females, and ranged in age from 70 to 72 years. They were kept at rest in bed after detection of the proximal deep vein thrombosis, and administered anti-coagulation and dissolution drugs. We observed the proximal deep vein thrombosis once a week using venous compression ultrasonography, and when the thrombosis had disappeared or was reduced, ambulation was allowed. As a result, we were able to prevent pulmonary embolism in these three patients.