ArticleKnee surgery & related research2020
Serum D-dimer should not be used in the diagnosis of venous thromboembolism within 28 days of total knee replacement surgery.
Article in Knee surgery & related research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Assessment of Hypercoagulability After Orthopedic Trauma Surgery Using Coagulation Biomarkers and TEG/ROTEM.International journal of molecular sciences · 2026Review
- Incidence of deep venous thrombosis in patients with hemophilia undergoing bilateral simultaneous total knee arthroplasty: a retrospective cohort study.BMC musculoskeletal disorders · 2024Article
- Incidence and preventive treatment for deep vein thrombosis with our own preventive protocol in total hip and knee arthroplasty.PloS one · 2024Article
- Article
- D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerum D-dimer is frequently used to rule out a diagnosis of venous thromboembolism (VTE), a recognised complication following total knee replacement (TKR). TKR is known to cause a rise in D-dimer levels, reducing its specificity. Previous studies have demonstrated that D-dimer remains elevated within 10 days of TKR and therefore should be avoided. The aim of this study was to determine whether serum D-dimer tests are clinically appropriate in identifying VTE when performed within 28 days of TKR.
methodsCase notes for patients who had a serum D-dimer test performed for clinically suspected VTE at ≥ 28 days following TKR were retrospectively reviewed for a 6-year period. Demographics, D-dimer result, time after surgery and further radiological investigations were recorded.
resultsFifty patients underwent D-dimer tests at ≥ 28 days following surgery (median 60 days, range 29-266); 48 of these patients had a positive result. Of these, five had confirmed VTE on radiological investigations. Serum D-dimer was raised in 96% of the patients. Only 10.42% of these patients had confirmed VTE. No patients with negative D-dimers had confirmed VTE.
conclusionsThese findings suggest that serum D-dimer remains raised for at least 28 days and possibly considerably longer following TKR. Serum D-dimer should not be used in patients with clinically suspected VTE within this period because of its unacceptably low specificity of 4.44% and positive predictive value of 10.42%, which can lead to a delay in necessary further radiological investigations, waste of resources and unnecessary exposure to harm.
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