To assess the value of color Doppler ultrasonography (CDUS) in diagnosing deep venous thrombosis (DVT) of the lower limbs in the perioperative period of total knee arthroplasty (TKA).

Eighty-one patients who would underwent unilateral TKA at Beijing Longfu Hospital from January 2016 to December 2016 were selected. Preoperatively, CDUS was used to examine the veins of the lower limbs as well as thrombosis, valvular function, and varicose veins. The incidence of DVT in the lower extremities was examined on the second, fifth, seventh, and fourteenth days after surgery. Anticoagulant therapy was strengthened, and patients with thrombosis were monitored. The possible risk factors for DVT were analyzed by multivariate Logistic regression analysis.

No deep vein thrombosis was detected before operation, but 29 cases of femoral vein reflux and 26 cases of varicose veins were detected. Postoperatively, 25 cases of lower extremity DVT were detected, all of which occurred within 1 week after surgery, including 6 cases detected on the 2nd day after surgery, 12 cases on the 3rd to 5th days, and 7 cases on the 6th to 7th days. After 14 days of intensive anticoagulant and thrombolytic treatment, eight cases of isolated thrombolysis were detected, and the thrombi of the remaining patients all decreased to varying degrees. All the thrombi did not develop toward the proximal end and showed no symptoms of pulmonary embolism. Multivariate Logistic regression analysis showed that femoral venous reflux, varicose veins, and hypertension were risk factors for postoperative DVT of the lower limbs, with the risk increased by 7.42, 7.38, and 7.34 times, respectively.

CDUS can not only screen out patients at a high risk for DVT of the lower limbs, but also detect and monitor the formation of DVT of the lower limbs after TKA operation, which is of great value for clinical prevention and individualized intervention.