Agarwal Saurabh, Rana Ashish, Gupta Gaurav, Raghav Deepak, Sharma Rajeev K
Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India.
J Orthop Case Rep. 2017 Jan-Feb;7(1):16-19. doi: 10.13107/jocr.2250-0685.668.
Deep vein thrombosis (DVT) following total knee arthroplasty (TKA) and its associated complication, pulmonary thromboembolism (PTE) remains a challenge for orthopedic surgeons. There are wide ranges of predisposing factors which are both patient specific as well as procedure associated, responsible for DVT. PTE is a well-known fatal complication of DVT which may be life-threatening. Medical management and early mobilization are necessary for the management of DVT. Fatal PTE can be prevented by implantation of inferior vena cava (IVC) filter in at risk patients.
We are presenting a rare case report of 75-year-old female with severe osteoarthritis of the left knee with DVT of the left lower limb in which TKA was done in a prediagnosed case of DVT. IVC filter placement was done before TKA for prevention of fatal PTE, and medical management was done for DVT.
Prevention of fatal thromboembolism is of prime importance in the management of DVT. This can be achieved by implanting IVC filter. TKA is necessary for early pain free mobilization of the patient, which prevents progression of DVT and early recovery. IVC filter placement prevents fatal thromboembolism. Hence, treatment of both osteoarthritis of knee by TKA and DVT can be done simultaneously.
全膝关节置换术（TKA）后发生的深静脉血栓形成（DVT）及其相关并发症肺血栓栓塞症（PTE）仍然是骨科医生面临的一项挑战。导致DVT的诱发因素众多，既有患者个体因素，也与手术相关。PTE是一种众所周知的DVT致命并发症，可能危及生命。药物治疗和早期活动对于DVT的管理很有必要。对于高危患者，植入下腔静脉（IVC）滤器可预防致命性PTE。
我们报告一例罕见病例，一名75岁女性，患有左膝重度骨关节炎并左下肢DVT，在已确诊DVT的情况下进行了TKA手术。在TKA术前放置了IVC滤器以预防致命性PTE，并对DVT进行了药物治疗。
在DVT的管理中，预防致命性血栓栓塞至关重要。这可以通过植入IVC滤器来实现。TKA对于患者早期无痛活动很有必要，可防止DVT进展并促进早期康复。IVC滤器置入可预防致命性血栓栓塞。因此，可同时通过TKA治疗膝关节骨关节炎和DVT。
