Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty

Objective. We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic deep vein thrombosis (DVT) at 3 months followup. Methods. We reviewed 1460 patients from our joint registry undergoing primary, unilateral TKR between 1998-2006. Demographic variables of age, sex, comorbidity, and education were retrieved. Metabolic syndrome was defined as body mass index above 30 kg/m(2), diabetes, hypertension, and hypercholesterolemia. Logistic regression was used to examine the relationship of metabolic syndrome on the incidence of DVT. Results. The overall incidence of symptomatic DVT was 4.4% (65/1460). Patients with metabolic syndrome had an increased incidence of DVT compared to those without metabolic syndrome (15.5% vs 3.4%). Adjusted analysis showed that the risk of symptomatic DVT in patients with metabolic syndrome was 3.2 times [odds ratio 3.2, 95% CI (1.0,15.4), p = 0.04] the risk in those without metabolic syndrome. Conclusion. Hospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients with metabolic syndrome. (First Release August 15 2009; J Rheumatol 2009;36:2298-301; doi: 10.3899/jrheum.090282)