Frequency of deep vein thrombosis in patients undergoing total knее replacement using pneumatic tourniquet

Abstract

Objectives: To assess the incidence of deep vein thrombosis in patients undergoing total knee replacement (TKR) with pneumatic tourniquet, using color doppler ultrasound.

Methodology: A descriptive study was performed in the Department of Orthopaedics & Traumatology, Indus Hospital & Health Network, Karachi between six months from 1st January 2025 to 1st June 2025. A total of 53 patients were included in this study over six months. All of them met the inclusion criteria and completed the follow-up. Pre- and post-operative ultrasound examination of lower limbs was carried out on day zero, day three, and day 28 for DVT surveillance. All of these patients were operated under regional anesthesia and received aspirin 75-mg post-operatively once daily for three weeks. Structured rehabilitation and ambulation were started on Day-1 of surgery. Demographic and clinical data, as well as comorbidities and body mass index, were recorded on a structured proforma. The analysis of the data was performed using SPSS version 26.

Results: Among 53 patients (75.5% females; mean age 58.17 ± 9.67 years), most were obese with hypertension or diabetes. No pre- or postoperative DVT was detected.

Conclusions: There was no incidence of DVT in any patient pre-operatively and post-operatively. This is in contrast to higher post-operative DVT rates reported worldwide in patients operated with a pneumatic tourniquet. This suggests that despite routine thromboprophylaxis and use of a pneumatic tourniquet, the incidence of DVT does not increase in well-screened patients who undergo early post-operative rehabilitation although we did not have a comparison group to make an inference.