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A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty

Received: 19 September 2018     Accepted: 26 October 2018     Published: 28 November 2018
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Abstract

Deep vein thrombosis is one of the main complications of total knee arthroplasty. Hematoma is another complication often seen following total knee arthroplasty, but a search of the literature found no reports of deep vein thrombosis caused by hematoma. A case of a 68-year-old woman with knee osteoarthritis who underwent total knee arthroplasty, with subsequent onset of thrombosis caused by hematoma, is reported. The surgery was performed through the medial parapatellar approach with measured resection and the implant was put in place with cement fixation. On postoperative day 7, there was still leakage of exudate from the wound, and swelling of the lower leg appeared. Therefore, infection or thrombosis was suspected, and contrast-enhanced computed tomography was performed. Accumulation of fluid was found from the thigh to the knee, and when paracentesis was carried out, blood was drawn, resulting in a diagnosis of hematoma. In addition, the blood vessels were under pressure from the hematoma, and thrombosis was diagnosed based on the clinical, blood analysis, and ultrasound findings. There was concern about treatment due to coexistence of hematoma and thrombi, but through application of a Robert Jones bandage and administration of edoxaban, the patient made good progress with no major complications. A case of deep vein thrombosis caused by hematoma following total knee arthroplasty was reported. The patient recovered without major complications through administration of edoxaban and application of a Robert Jones bandage.

Published in Clinical Medicine Research (Volume 7, Issue 5)
DOI 10.11648/j.cmr.20180705.15
Page(s) 131-134
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Total Knee Arthroplasty, Deep Venous Thrombosis, Anticoagulant

References
[1] Mao Lin He, Zeng Ming Xiao, Ming Lei et al. Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty. Cochrane Database Syst Rev. 2014;7:CD008207.
[2] Ning Liu, Simin Luo, Cheanglek Hang et al. Changes in coagulation functions and hemorheological parameters may predict hematoma formation after total knee arthroplasty. J Orthop Surg Res. 2016;11:35.
[3] Mackman N. New insights into the mechanisms of venous thrombosis. J Clin Invest. 2012;122:2331-2336.
[4] Schulz C, Engelmann B, Massberg S. Crossroads of coagulation and innate immunity: the case of deep vein thrombosis. J Thromb Haemost. 2013;11(Suppl 1):233-241.
[5] Esler CN, Blackeway C, Fiddian NJ. The use of a closed-suction drain in total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Br. 2003;85(2):215-7.
[6] Bin Li, Yu Wen, Haishan Wu et al. The effect of tourniquet use on hidden blood loss in total knee arthroplasty. Int Orthop. 2009;33(5):1263-8.
[7] Jun Liu, Yao-min Li, Jian-gang Cao et al. Effects of knee position on blood loss following total knee arthroplasty: a randomized, controlled study. J Orthop Surg Res. 2015;10:69.
[8] Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014;35:3033-3069.
[9] Kearon C, Akl EA, Comerota AJ et al. Antithrombotic therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 2016;149(2):315-52.
[10] Kearon C, Akl EA, Ornelas J et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th de: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S-494S.
[11] Hokusai-VTE Investigations, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369:1406-1415.
[12] Nakamura M, Wang YQ, Wang C et al. Efficacy and safety of edoxaban for treatment of venous thromboembolism: a subanalysis of East Asian patients in the Hokusai-VTE trial. J Thromb Haemost. 2015;13:1606-1614.
[13] Brodell JD, Axon DL, Evarts CM. The Robert Jones bandage. J Bone Joint Surg Br. 1986;68:776-779.
[14] Charalambides C, Beer M, Melhuish J et al. Bandaging technique after knee replacement. Acta Orthop. 2005;76:89-94.
[15] Piya Pinsornsak, Sukanis Chumchuen. Can a modified Robert Jones bandage after knee arthroplasty reduce blood loss? A prospective randomized controlled trial. Clin Orthop Relat Res. 2013;471(5):1677-81.
Cite This Article
  • APA Style

    Takenori Tomite, Hidetomo Saito, Hiroaki Kijima, Kimio Saito, Noriyuki Ishikawa, et al. (2018). A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty. Clinical Medicine Research, 7(5), 131-134. https://doi.org/10.11648/j.cmr.20180705.15

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    ACS Style

    Takenori Tomite; Hidetomo Saito; Hiroaki Kijima; Kimio Saito; Noriyuki Ishikawa, et al. A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty. Clin. Med. Res. 2018, 7(5), 131-134. doi: 10.11648/j.cmr.20180705.15

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    AMA Style

    Takenori Tomite, Hidetomo Saito, Hiroaki Kijima, Kimio Saito, Noriyuki Ishikawa, et al. A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty. Clin Med Res. 2018;7(5):131-134. doi: 10.11648/j.cmr.20180705.15

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  • @article{10.11648/j.cmr.20180705.15,
      author = {Takenori Tomite and Hidetomo Saito and Hiroaki Kijima and Kimio Saito and Noriyuki Ishikawa and Yuji Hatakeyama and Hiroshi Tazawa and Satoshi Yumoto and Ryo Syoji and Toshiaki Aizawa and Naohisa Miyakoshi and Yoichi Shimada},
      title = {A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty},
      journal = {Clinical Medicine Research},
      volume = {7},
      number = {5},
      pages = {131-134},
      doi = {10.11648/j.cmr.20180705.15},
      url = {https://doi.org/10.11648/j.cmr.20180705.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20180705.15},
      abstract = {Deep vein thrombosis is one of the main complications of total knee arthroplasty. Hematoma is another complication often seen following total knee arthroplasty, but a search of the literature found no reports of deep vein thrombosis caused by hematoma. A case of a 68-year-old woman with knee osteoarthritis who underwent total knee arthroplasty, with subsequent onset of thrombosis caused by hematoma, is reported. The surgery was performed through the medial parapatellar approach with measured resection and the implant was put in place with cement fixation. On postoperative day 7, there was still leakage of exudate from the wound, and swelling of the lower leg appeared. Therefore, infection or thrombosis was suspected, and contrast-enhanced computed tomography was performed. Accumulation of fluid was found from the thigh to the knee, and when paracentesis was carried out, blood was drawn, resulting in a diagnosis of hematoma. In addition, the blood vessels were under pressure from the hematoma, and thrombosis was diagnosed based on the clinical, blood analysis, and ultrasound findings. There was concern about treatment due to coexistence of hematoma and thrombi, but through application of a Robert Jones bandage and administration of edoxaban, the patient made good progress with no major complications. A case of deep vein thrombosis caused by hematoma following total knee arthroplasty was reported. The patient recovered without major complications through administration of edoxaban and application of a Robert Jones bandage.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - A Case of Deep Vein Thrombosis Caused by Hematoma Following Total Knee Arthroplasty
    AU  - Takenori Tomite
    AU  - Hidetomo Saito
    AU  - Hiroaki Kijima
    AU  - Kimio Saito
    AU  - Noriyuki Ishikawa
    AU  - Yuji Hatakeyama
    AU  - Hiroshi Tazawa
    AU  - Satoshi Yumoto
    AU  - Ryo Syoji
    AU  - Toshiaki Aizawa
    AU  - Naohisa Miyakoshi
    AU  - Yoichi Shimada
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    DO  - 10.11648/j.cmr.20180705.15
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 131
    EP  - 134
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20180705.15
    AB  - Deep vein thrombosis is one of the main complications of total knee arthroplasty. Hematoma is another complication often seen following total knee arthroplasty, but a search of the literature found no reports of deep vein thrombosis caused by hematoma. A case of a 68-year-old woman with knee osteoarthritis who underwent total knee arthroplasty, with subsequent onset of thrombosis caused by hematoma, is reported. The surgery was performed through the medial parapatellar approach with measured resection and the implant was put in place with cement fixation. On postoperative day 7, there was still leakage of exudate from the wound, and swelling of the lower leg appeared. Therefore, infection or thrombosis was suspected, and contrast-enhanced computed tomography was performed. Accumulation of fluid was found from the thigh to the knee, and when paracentesis was carried out, blood was drawn, resulting in a diagnosis of hematoma. In addition, the blood vessels were under pressure from the hematoma, and thrombosis was diagnosed based on the clinical, blood analysis, and ultrasound findings. There was concern about treatment due to coexistence of hematoma and thrombi, but through application of a Robert Jones bandage and administration of edoxaban, the patient made good progress with no major complications. A case of deep vein thrombosis caused by hematoma following total knee arthroplasty was reported. The patient recovered without major complications through administration of edoxaban and application of a Robert Jones bandage.
    VL  - 7
    IS  - 5
    ER  - 

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Author Information
  • Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

  • Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Kitaakita Municipal Hospital, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

  • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

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