Influencing Factors and Construction of a Predictive Model for Lower Extremity Deep Vein Thrombosis after Total Knee Arthroplasty

OBJECTIVE: To identify risk factors for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) and to develop a predictive nomogram model. STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Orthopaedics, Nanjing Pukou People's Hospital, Liangjiang Hospital, Southeast University, Nanjing, China, from March 2018 to March 2022. METHODOLOGY: Among the 1,015 eligible TKA patients, 457 developed postoperative DVT (DVT group), and 558 served as controls (non-DVT group). Risk factors were identified through univariate analysis and multivariate logistic regression. RESULTS: The DVT group showed significantly higher proportions of patients aged age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer levels >0.545 mg/L, and von Willebrand factor (vWF) level >178.55 ng/mL (all p <0.05) vs. the non-DVT group. Independent risk factors for DVT included age ≥65 years, BMI ≥28 kg/m2, female gender, history of diabetes, cemented prosthesis, operation duration ≥90 minutes, bed rest duration ≥72 hours, no mechanical thromboprophylaxis, D-dimer >0.545 mg/L, and vWF >178.55 ng/mL. A predictive nomogram incorporated these variables using regression coefficients (e.g., age × 1.128 ... vWF × 6.225; intercept = 4.545). CONCLUSION: Key modifiable and non-modifiable factors influence the risk of DVT following TKA. The predictive validated nomogram demonstrates clinical utility for individualised risk stratification and prevention strategies. KEY WORDS: Total knee arthroplasty, Deep vein thrombosis, Risk factors, Predictive model.