Diagnostic value of D-dimer in screening for deep vein thrombosis after total joint arthroplasty: a meta-analysis.
Negative D-dimer results are most useful for ruling out deep vein thrombosis after joint replacement
Diagnostic value of D-dimer in screening for deep vein thrombosis after total joint arthroplasty: a meta-analysis.
Deep vein thrombosis (deep vein thrombosis) is a common and serious complication following total hip arthroplasty (total hip arthroplasty) and total knee arthroplasty (total knee arthroplasty).
This meta-analysis aimed to systematically evaluate the diagnostic performance of D-dimer for screening deep vein thrombosis after total joint arthroplasty (total joint arthroplasty).
PubMed, Web of Science, Wiley Library, China National Knowledge Infrastructure (China National Knowledge Infrastructure), Wanfang Data, and VIP databases were searched from inception to November 2025 for studies that investigated the diagnostic accuracy of D-dimer for detecting deep vein thrombosis after total joint arthroplasty.
a negative result mostly rules out deep vein thrombosis after joint replacement
The pooled sensitivity and specificity of D-dimer for diagnosing postoperative deep vein thrombosis after total joint arthroplasty were 0.76 (95% CI: 0.64-0.85) and 0.86 (95% CI: 0.55-0.97), respectively.
The AUC of the summary receiver operating characteristic curve was 0.83 (95% CI: 0.80-0.86).
Substantial heterogeneity was observed among studies (I 2 > 98%), which was mainly attributable to differences in diagnostic cutoff values.
D-dimer demonstrates moderate diagnostic potential for screening deep vein thrombosis after total joint arthroplasty, with its primary value lying in ruling out deep vein thrombosis when results are negative.
However, the current pooled estimates do not support a uniform diagnostic threshold or the use of D-dimer as a standalone diagnostic tool.