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Open Access 01-12-2022 | Phlebothrombosis | Research

Does diabetes mellitus increase the incidence of early thrombosis in deep vein following unicompartmental knee arthroplasty: a retrospective cohort study

Authors: Xufeng Jiao, Zheng Li, Shuai An, Jiang Huang, Mingli Feng, Guanglei Cao

Published in: BMC Geriatrics | Issue 1/2022

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Abstract

Background

Many patients following unicompartmental knee arthroplasty (UKA) also suffer from diabetes mellitus, which may lead to an increased likelihood of postoperative deep venous thrombosis (DVT). Therefore, we evaluated whether DVT incidence would increase 3 days following UKA in diabetic patients.

Methods

Patients who underwent UKA from August 2018 to September 2021 in our hospital were retrospectively included. Age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure and time, and glycosylated hemoglobin concentration were recorded as confounders. We compared the incidence and type of DVT between non-diabetic and diabetic patients and evaluated the effect of glycosylated hemoglobin levels on DVT.

Results

Of all the 224 patients, 96 had diabetes and 128 did not. Within 3 days after surgery, DVT occurred in 25 cases in the diabetic group and 17 cases in the non-diabetic group (p < 0.05), and the difference mainly exists in the lower limbs on the surgical side. Logistic regression analysis demonstrated that the risk of DVT in the diabetic group was 4.50 times higher compared with the non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.35 times. Differences in age, gender, body mass index, hypertension, mode of anesthesia, surgery time, intraoperative blood loss, tourniquet pressure, and time between the two groups were not significant.

Conclusions

The incidence of DVT in diabetic patients within 3 days after UKA was significantly higher than that in non-diabetic patients and was proportional to the concentration of glycosylated hemoglobin.
Literature
1.
go back to reference Schindler OS, Dalziel R. Post-thrombotic syndrome after total hip or knee arthroplasty: incidence in patients with asymptomatic deep venous thrombosis. J Orthop Surg (Hong Kong). 2005;13:113–9.CrossRef Schindler OS, Dalziel R. Post-thrombotic syndrome after total hip or knee arthroplasty: incidence in patients with asymptomatic deep venous thrombosis. J Orthop Surg (Hong Kong). 2005;13:113–9.CrossRef
2.
go back to reference Zhang H, Mao P, Wang C, Chen D, Xu Z, Shi D, Dai J, Yao Y, Jiang Q. Incidence and risk factors of deep vein thrombosis (DVT) after total hip or knee arthroplasty: a retrospective study with routinely applied venography. Blood Coagul Fibrinolysis. 2017;28:126–33.CrossRef Zhang H, Mao P, Wang C, Chen D, Xu Z, Shi D, Dai J, Yao Y, Jiang Q. Incidence and risk factors of deep vein thrombosis (DVT) after total hip or knee arthroplasty: a retrospective study with routinely applied venography. Blood Coagul Fibrinolysis. 2017;28:126–33.CrossRef
3.
4.
go back to reference Fuller JH, Keen H, Jarrett RJ, Omer T, Meade TW, Chakrabarti R, North WR, Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J. 1979;2:964–6.CrossRef Fuller JH, Keen H, Jarrett RJ, Omer T, Meade TW, Chakrabarti R, North WR, Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J. 1979;2:964–6.CrossRef
5.
go back to reference Mustard JF, Packham MA. Platelets and diabetes mellitus. N Engl J Med. 1977;297:1345–7.CrossRef Mustard JF, Packham MA. Platelets and diabetes mellitus. N Engl J Med. 1977;297:1345–7.CrossRef
6.
go back to reference Fearnley GR, Chakrabarti R, Avis PR. Blood fibrinolytic activity in diabetes mellitus and its bearing on ischaemic heart disease and obesity. Br Med J. 1963;1:921–3.CrossRef Fearnley GR, Chakrabarti R, Avis PR. Blood fibrinolytic activity in diabetes mellitus and its bearing on ischaemic heart disease and obesity. Br Med J. 1963;1:921–3.CrossRef
7.
go back to reference Petrauskiene V, Falk M, Waernbaum I, Norberg M, Eriksson JW. The risk of venous thromboembolism is markedly elevated in patients with diabetes. Diabetologia. 2005;48:1017–21.CrossRef Petrauskiene V, Falk M, Waernbaum I, Norberg M, Eriksson JW. The risk of venous thromboembolism is markedly elevated in patients with diabetes. Diabetologia. 2005;48:1017–21.CrossRef
8.
go back to reference Humar A, Johnson EM, Gillingham KJ, Sutherland DE, Payne WD, Dunn DL, Wrenshall LE, Najarian JS, Gruessner RW, Matas AJ. Venous thromboembolic complications after kidney and kidney-pancreas transplantation: a multivariate analysis. Transplantation. 1998;65:229–34.CrossRef Humar A, Johnson EM, Gillingham KJ, Sutherland DE, Payne WD, Dunn DL, Wrenshall LE, Najarian JS, Gruessner RW, Matas AJ. Venous thromboembolic complications after kidney and kidney-pancreas transplantation: a multivariate analysis. Transplantation. 1998;65:229–34.CrossRef
9.
go back to reference Zhao Z, Wang S, Ma W, Kong G, Zhang S, Tang Y, Zhao Y. Diabetes mellitus increases the incidence of deep vein thrombosis after total knee arthroplasty. Arch Orthop Trauma Surg. 2014;134:79–83.CrossRef Zhao Z, Wang S, Ma W, Kong G, Zhang S, Tang Y, Zhao Y. Diabetes mellitus increases the incidence of deep vein thrombosis after total knee arthroplasty. Arch Orthop Trauma Surg. 2014;134:79–83.CrossRef
10.
go back to reference Lombardi AJ, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA. Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res. 2009;467:1450–7.CrossRef Lombardi AJ, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA. Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res. 2009;467:1450–7.CrossRef
11.
go back to reference Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della VC. Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J ARTHROPLASTY. 2012;27:86–90.CrossRef Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della VC. Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J ARTHROPLASTY. 2012;27:86–90.CrossRef
12.
go back to reference Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J ARTHROPLASTY. 2008;23:408–12.CrossRef Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J ARTHROPLASTY. 2008;23:408–12.CrossRef
13.
go back to reference Parvizi J, Huang R, Raphael IJ, Maltenfort MG, Arnold WV, Rothman RH. Timing of Symptomatic Pulmonary Embolism with Warfarin Following Arthroplasty. J ARTHROPLASTY. 2015;30:1050–3.CrossRef Parvizi J, Huang R, Raphael IJ, Maltenfort MG, Arnold WV, Rothman RH. Timing of Symptomatic Pulmonary Embolism with Warfarin Following Arthroplasty. J ARTHROPLASTY. 2015;30:1050–3.CrossRef
14.
go back to reference Granziera S, Cohen AT. VTE primary prevention, including hospitalised medical and orthopaedic surgical patients. Thromb Haemost. 2015;113:1216–23.CrossRef Granziera S, Cohen AT. VTE primary prevention, including hospitalised medical and orthopaedic surgical patients. Thromb Haemost. 2015;113:1216–23.CrossRef
15.
go back to reference Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41:3–14.CrossRef Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41:3–14.CrossRef
16.
go back to reference Drouet L. Venous thromboembolic pathology. New acquired risk factors or new data on acquired risk factors. Arch Mal Coeur Vaiss. 2011;94:1318–26. Drouet L. Venous thromboembolic pathology. New acquired risk factors or new data on acquired risk factors. Arch Mal Coeur Vaiss. 2011;94:1318–26.
17.
go back to reference Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med. 2002;162:1182–9.CrossRef Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med. 2002;162:1182–9.CrossRef
18.
go back to reference Bergqvist D, Bergentz SE, Bornmyr S, Husberg B, Konrad P, Ljungner H. Deep vein thrombosis after renal transplantation: a prospective analysis of frequency and risk factors. EUR SURG RES. 1985;17:69–74.CrossRef Bergqvist D, Bergentz SE, Bornmyr S, Husberg B, Konrad P, Ljungner H. Deep vein thrombosis after renal transplantation: a prospective analysis of frequency and risk factors. EUR SURG RES. 1985;17:69–74.CrossRef
19.
go back to reference Deng W, Huo L, Yuan Q, Huang D, Li Q, Tian W. Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty. BMC Musculoskelet Disord. 2021;22:608.CrossRef Deng W, Huo L, Yuan Q, Huang D, Li Q, Tian W. Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty. BMC Musculoskelet Disord. 2021;22:608.CrossRef
20.
go back to reference Badireddy M, Mudipalli VR. Deep Venous Thrombosis Prophylaxis. 2021 Aug 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30521286. Badireddy M, Mudipalli VR. Deep Venous Thrombosis Prophylaxis. 2021 Aug 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30521286.
21.
go back to reference Choi HK, Rho YH, Zhu Y, Cea-Soriano L, Avina-Zubieta JA, Zhang Y. The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a UK population-based outpatient cohort study. ANN RHEUM DIS. 2013;72:1182–7.CrossRef Choi HK, Rho YH, Zhu Y, Cea-Soriano L, Avina-Zubieta JA, Zhang Y. The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: a UK population-based outpatient cohort study. ANN RHEUM DIS. 2013;72:1182–7.CrossRef
22.
go back to reference Mori N, Kimura S, Onodera T, Iwasaki N, Nakagawa I, Masuda T. Use of a pneumatic tourniquet in total knee arthroplasty increases the risk of distal deep vein thrombosis: A prospective, randomized study. KNEE. 2016;23:887–9.CrossRef Mori N, Kimura S, Onodera T, Iwasaki N, Nakagawa I, Masuda T. Use of a pneumatic tourniquet in total knee arthroplasty increases the risk of distal deep vein thrombosis: A prospective, randomized study. KNEE. 2016;23:887–9.CrossRef
23.
go back to reference Harrison-Brown M, Scholes C, Douglas SL, Farah SB, Kerr D, Kohan L. Multimodal thromboprophylaxis in low-risk patients undergoing lower limb arthroplasty: A retrospective observational cohort analysis of 1400 patients with ultrasound screening. J Orthop Surg (Hong Kong). 2020;28:2309499020926790.CrossRef Harrison-Brown M, Scholes C, Douglas SL, Farah SB, Kerr D, Kohan L. Multimodal thromboprophylaxis in low-risk patients undergoing lower limb arthroplasty: A retrospective observational cohort analysis of 1400 patients with ultrasound screening. J Orthop Surg (Hong Kong). 2020;28:2309499020926790.CrossRef
24.
go back to reference Kanchanabat B, Stapanavatr W, Meknavin S, Soorapanth C, Sumanasrethakul C, Kanchanasuttirak P. Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis. Br J Surg. 2011;98:1356–64.CrossRef Kanchanabat B, Stapanavatr W, Meknavin S, Soorapanth C, Sumanasrethakul C, Kanchanasuttirak P. Systematic review and meta-analysis on the rate of postoperative venous thromboembolism in orthopaedic surgery in Asian patients without thromboprophylaxis. Br J Surg. 2011;98:1356–64.CrossRef
25.
go back to reference Wang CJ, Huang CC, Yu PC, Chen HH. Diagnosis of deep venous thrombosis after total knee arthroplasty: a comparison of ultrasound and venography studies. Chang Gung Med J. 2004;27:16–21.PubMed Wang CJ, Huang CC, Yu PC, Chen HH. Diagnosis of deep venous thrombosis after total knee arthroplasty: a comparison of ultrasound and venography studies. Chang Gung Med J. 2004;27:16–21.PubMed
26.
go back to reference Li F, Wang X, Huang W, Ren W, Cheng J, Zhang M, Zhao Y. Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb. Phlebology. 2014;29:442–6.CrossRef Li F, Wang X, Huang W, Ren W, Cheng J, Zhang M, Zhao Y. Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb. Phlebology. 2014;29:442–6.CrossRef
27.
go back to reference Hughes MJ, Stein PD, Matta F. Silent pulmonary embolism in patients with distal deep venous thrombosis: systematic review. THROMB RES. 2014;134:1182–5.CrossRef Hughes MJ, Stein PD, Matta F. Silent pulmonary embolism in patients with distal deep venous thrombosis: systematic review. THROMB RES. 2014;134:1182–5.CrossRef
28.
go back to reference Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. ANN INTERN MED. 2004;141:421–31.CrossRef Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. ANN INTERN MED. 2004;141:421–31.CrossRef
29.
go back to reference Weinmann EE, Salzman EW. Deep-vein thrombosis. N Engl J Med. 1994;331:1630–41.CrossRef Weinmann EE, Salzman EW. Deep-vein thrombosis. N Engl J Med. 1994;331:1630–41.CrossRef
30.
go back to reference Zhou L.Y., Gu W., Liu Y, Ma Z.L. Effects of Inhalation Anesthesia vs. Total Intravenous Anesthesia (TIVA) vs. Spinal-Epidural Anesthesia on Deep Vein Thrombosis After Total Knee Arthroplasty. Med Sci Monit. 2018;24:67–75.CrossRef Zhou L.Y., Gu W., Liu Y, Ma Z.L. Effects of Inhalation Anesthesia vs. Total Intravenous Anesthesia (TIVA) vs. Spinal-Epidural Anesthesia on Deep Vein Thrombosis After Total Knee Arthroplasty. Med Sci Monit. 2018;24:67–75.CrossRef
31.
go back to reference Saleh J, El-Othmani MM, Saleh KJ. Deep Vein Thrombosis and Pulmonary Embolism Considerations in Orthopedic Surgery. Orthop Clin North Am. 2017;48:127–35.CrossRef Saleh J, El-Othmani MM, Saleh KJ. Deep Vein Thrombosis and Pulmonary Embolism Considerations in Orthopedic Surgery. Orthop Clin North Am. 2017;48:127–35.CrossRef
Metadata
Title
Does diabetes mellitus increase the incidence of early thrombosis in deep vein following unicompartmental knee arthroplasty: a retrospective cohort study
Authors
Xufeng Jiao
Zheng Li
Shuai An
Jiang Huang
Mingli Feng
Guanglei Cao
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-022-03153-w

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