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Background  Deep vein thrombosis (DVT) is one of the most dangerous complications of total joint arthroplasty (TJA). Systemic inflammation has proved to have a great contribution to thrombosis and has been considered as a risk factor for DVT recently. The lymphocyte to monocyte ratio (LMR) and monocyte to high-density lipoprotein (HDL) ratio (MHR) are two biomarkers used widely for systemic inflammation. This study aims to find out the potential predictive value of LMR and MHR for DVT after TJA.    Methods  A total of 853 patients who underwent primary TJA were finally included in this retrospective study. Acute DVT after TJA was evaluated by venography. Preoperative and postoperative LMR and MHR were calculated according to the blood routine test and blood biochemistry test. The association between LMR or MHR and DVT and their predictive value were evaluated by multiple logistic regression analysis and ROC curve respectively.    Results  Totally, 126 patients (14.8%) were diagnosed with DVT by venography. Patients with DVT had a significantly higher level of preoperative MHR ( P  < 0.001) and postoperative MHR ( P  < 0.001), along with a significantly lower level of preoperative LMR ( P  < 0.001) and postoperative LMR ( P  < 0.001). Multiple logistic regression indicated that BMI (OR = 1.10,  P  = 0.001), preoperative LMR (OR = 0.72, P<0.001), and postoperative LMR (OR = 0.32,  P  < 0.001) were independent risk factors for DVT. Besides, BMI (OR = 1.17,  P  = 0.001), female (OR = 4.6,  P  = 0.004), preoperative MHR (OR = 10.43,  P  = 0.008), postoperative Hb (OR = 0.96,  P  = 0.002), and postoperative LMR were independently associated with symptomatic DVT. The ROC curve suggested that the postoperative LMR had a potential to predict DVT after TJA.    Conclusion  In summary, the present study found out a significant association of perioperative LMR or MHR with DVT after TJA. Moreover, the postoperative LMR had a potential to predict DVT accurately.

journal of orthopaedic surgery and research

Predictive value of lymphocyte to monocyte ratio and monocyte to high-density lipoprotein ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study