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Follow-up study of isolated calf muscular vein thrombosis for anticoagulant therapy after primary hip and knee arthroplasty

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Although isolated calf muscular vein thrombosis (ICMVT) is commonly seen after hip and knee arthroplasty, no treatment guidelines for ICMVT after joint replacement are available. The purpose of this study was to evaluate the outcomes of patients with ICMVT for anticoagulant therapy at different time points after primary hip and knee arthroplasty.

Methods

Patients with ICMVT after primary hip and knee arthroplasty were included in the study. Diagnosis was established with Doppler ultrasound. Patients were followed up clinically and with Doppler ultrasound at 1, 2, and 3 months. The outcomes were efficacy (complete resolution) and acceptability (hemorrhagic events). Anticoagulant therapy at curative dosage was prescribed for 1 month and was extended for 2 additional months in case of incomplete resolution at 1 month or if propagation was present. The chi-square test was used to compare the outcomes at different time points.

Results

302 patients were taken hip and knee arthroplasty from January 2021 to May 2022, in which 51 patients presented with 51 ICMVTs postoperatively. The incidence of ICMVT was about 16.89%. Resolution of ICMVT was considered complete at 1, 2, and 3 months at 36.73%, 61.22%, and 91.84%, respectively, with significant differences among the time points (P < 0.05). All patients with ICMVT receiving anticoagulant therapy remained free of propagations and hemorrhagic events within 3 months.

Conclusion

Our findings provide new insights into the anticoagulant therapy for ICMVT after primary hip and knee arthroplasty, taking oral Rivaroxaban for 3 months is effective and safe, which contributes to provide the reference for clinical practice.

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Availability of data and materials

All data generated or analyzed during this study are included in this published article.

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Funding

This study was supported by: The National Key R&D Program of China (No.2021YFA1102600), National Natural Science Foundation of China (No. 82002293), Science and Technology Planning Project of Guangzhou City, China (Grant No. 202201020495, 202201020481); Guangdong Basic and Applied Basic Research Foundation (Grant No. 2019A1515011647, 2021A1515010693, 2021A1515010294, 2022A1515010256). The funding agency had no role in designing the study, conducting the analysis, interpreting the data or writing the manuscript.

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Author notes

  1. Zhencheng Huang and Hao Sun contributed equally to this analysis.

Authors and Affiliations

  1. Department of Orthopedic, The Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510080, China

    Zhencheng Huang, Hao Sun, Deng Li, Zhiqing Cai, Meiyi Chen, Jie Xu & Ruofan Ma

  2. Department of Orthopedic, The Eighth Affiliated Hospital of Sun Yat-Sen University, 3025 Shennan Middle Road, Shenzhen, 518031, China

    Zhencheng Huang & Shuqiang Ma

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  1. Zhencheng Huang
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Contributions

All authors contributed to the study’s conception and design. Acquisition, analysis and interpretation of data were performed by ZCH and MYC. The first draft of the manuscript was written by ZCH. Critical revision of the manuscript was performed by HS, DL and ZQC. RFM, JX and SQM: final approval of the version, agree to be accountable for all aspects of the work. All authors have read and approved the manuscript.

Corresponding authors

Correspondence to Jie Xu or Ruofan Ma.

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The authors have no relevant financial or non-financial interests to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Sun Yat-sen University approved this study.

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Informed consent was obtained from all individual participants included in the study.

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Huang, Z., Sun, H., Li, D. et al. Follow-up study of isolated calf muscular vein thrombosis for anticoagulant therapy after primary hip and knee arthroplasty. Arch Orthop Trauma Surg 144, 7–13 (2024). https://doi.org/10.1007/s00402-023-05011-9

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