Mehroze Zamir, Muhammad Kazim Rahim Najjad, Naeem Yousuf, Syed Shahid Noor, Osama Intikhab, Imran Shabir Mughal, Muhammad Sufyan.
Can D-dimers detect the deep venous thromboembolism after total knee arthroplasty?.
Pak J Surg Jan ;31(2):124-7.

Objective: Our aim was to determine the frequency of deep vein thrombosis (DVT) in patients undergone Total Knee Arthoplasty (TKA ) using D-dimer as a screening tool. Study Design: Prospective cross sectional study Sett ing and duration: Liaquat National Hospital, Karachi, Pakistan. Between 1st March 2012 to 31st January 2013. Methodology: Patients aft er meeting inclusion and exclusion criteria underwent TKA . Blood was checked for D-dimer levels at 5 minutes before infl ation of tourniquet, at 1st post operative and at 7th post operative day. Ultrasound was also done on 7th post operative day for confi rmation of DVT. Results: A total of 114 patients who underwent TKA were evaluated. Th e incidence of DVT either symptomatic or sub-clinical in our sample was found to be 26%. Blood D-dimer levels in to context to detecting DVT had a sensitivity of 83%, with specifi city of 93%, a positive predictive value was 80% and a negative predictive value of 93%. Accuracy of detecting DVT by serum D-dimer levels which was confi rmed by ultrasound was 90%. Conclusion: A high level of D-dimer is highly specifi c and sensitive marker for diagnosing post operative deep vein thrombosis in post operative total knee arthoplasty patients. Alone D-dimer levels are not accurate enough to diagnose early DVT in TKA patient.

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