Objective To investigate the effect of preoperative old muscular calf vein thrombosis on the safety and effica-cy of total knee arthroplasty(TKA).Methods A total of 411 patients with end-stage knee osteoarthritis who underwent primary TKA in the First Affiliated Hospital of Nanjing Medical University from September 2021 to March 2023 were retrospectively ana-lyzed.There were 89 males and 322 females,aged 68.05±5.91 years(range,50-82 years).The body mass index was 26.8±3.7 kg/m2(range,17.4-39.8 kg/m2).The group was divided into a preoperative thrombosis group(47 cases)and a preoperative none-thrombo-sis group(364 cases)according to whether or not there was a combination of old muscular calf vein thrombosis before TKA.The clinical characteristics(location and size)and lower limb swelling were observed,and the American Knee Society(AKS)score,vi-sual analogue scale(VAS)and Villalta score were recorded to compare the differences between the two groups.Results All pa-tients successfully completed the operation and were followed up for 7.4±1.1 months(range,6-9 months).Postoperative deep ve-nous thrombosis(DVT)occurred in 96％(45/47)of the patients in the preoperative thrombus group,which was greater than the 38.5％(140/364)in the preoperative none-thrombus group,and the difference was statistically significant(x2=55.184,P＜0.001).29％(13/45)of the patients who developed DVT postoperatively in the preoperative thrombus group had DVT located in the main vein,which was greater than the 9％(12/140)in the preoperative none-thrombus group,and the difference was statistically signifi-cant(x2=12.028,P＜0.001).51％(23/45)of patients with DVT after operation had thrombosis ≥6 mm,which was higher than 34％(47/140)of patients in the preoperative none-thrombus group,and the difference was statistically significant(x2=4.454,P=0.035).The rate of thigh swelling on postoperative day 3 was 8.42％±3.50％in the group with preoperative thrombus and 7.80％±4.12％in the preoperative none-thrombus group,and the differences were not statistically significant(t=-0.995,P=0.320).The rate of calf swelling on postoperative day 3 was 8.14％±3.40％in the preoperative thrombus group,which was greater than the 5.51％±3.45％in the preoperative none-thrombus group,and the difference was statistically significant(t=-4.923,P＜0.001).Postoperative AKS scores were elevated in both groups and were greater than preoperative scores at 3 and 6 months postoperatively,with statistically significant differences(P＜0.05).There was no significant difference in AKS score between the two groups before operation(P＞0.05),and the AKS scores in the preoperative thrombus group were smaller than those in the preoperative none-thrombus group at 3 and 6 months postoperatively,with a statistically significant difference(P＜0.05).Postoperative VAS scores were reduced in both groups and were smaller than preoperative scores at 3 and 6 months postoperatively,with statistically significant differences(P＜0.05).There was no significant difference in preoperative VAS scores between the two groups(P＜0.05),and the VAS scores in the preoperative thrombus group were greater than those in the preoperative none-thrombus group at 3 and 6 months postoperatively,with a statistically significant difference(P＜0.05).The Villalta score of patients with DVT after operation in the preoperative thrombus group was 4.47±2.47 at the last follow-up,which was greater than that of the preoperative none-thrombus group,which was 2.90±1.92,and the difference was statistically significant(t=-4.395,P＜0.001).Conclusion Preoperative combined old mus-cular calf vein thrombosis increases the incidence of postoperative DVT and the dangerousness of DVT is higher.
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