[Evaluation of the predictive value of fibrin degradation products in the detection of deep venous thrombosis after total knee prosthesis]. / Evaluation de l'intérêt prédictif des produits de dégradation de la fibrine (PDFb) en ELISA dans le dépistage des thromboses veineuses profondes après prothèse totale du genou.

ABSTRACT

The total knee arthroplasty (TKA) favours deep venous thrombosis (DVT), more often sural thrombosis. In this case, pulmonary embolism is exceptional but sural thrombosis can give a poor functional prognostic by trophic disorders. The purpose of this work is to verify the predictive value of D-Dimer by Elisa technic in the detection of DVT after TKA. We have studied 42 TKA at the Edouard HERRIOT Hospital(Lyon) between April 2, 1992 and October 20, 1994. Patients were divided in two groups with DVT (n = 5) and without DVT (n = 37). Prophylactic heparinotherapy was systematic. The biologic follow-up by ELISA technic(Fibrinostika FbDP, Organon Teknika) of the D-Dimer were realized at D0 (Day 0) preoperative period and D1, D4, and D6 postoperative period. An echo-Doppler exam were effected at D8 postoperative. The analysis of mean rate of the D-Dimer didn't show significative difference between the two groups at D0, D1, D4 and D6. But, we observed that the rate of D-Dimer increased after TKA significantly in both groups. We can't evaluate predictive interest of the D-Dimer after TKA but the little number of DVT authorizes to pursue this study and to moderate our conclusion.