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Duplex ultrasonography after total hip or knee arthroplasty
1Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, S.A.R. peterko@graduate.hku.hk
International Orthopaedics
|June 12, 2003
Summary
Isolated distal deep vein thrombosis (DVT) is common but asymptomatic in low-risk Chinese patients after hip or knee replacement. Monitoring with duplex ultrasonography may be considered if anticoagulation is not used.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
- Diagnostic Imaging
Background:
- Deep vein thrombosis (DVT) is a potential complication following major orthopedic surgery.
- Routine pharmacologic anticoagulation is not universally applied in all patient populations undergoing arthroplasty.
Purpose of the Study:
- To investigate the incidence and clinical significance of DVT in Chinese patients undergoing total hip (THR) or knee (TKR) arthroplasty without pharmacological anticoagulation.
- To evaluate the utility of duplex ultrasonography for monitoring DVT in this cohort.
Main Methods:
- Prospective study of 80 patients (22 THR, 58 TKR) aged 68 years, excluding high-risk DVT individuals.
- Postoperative duplex ultrasonography on postoperative days 5-7 to detect DVT.
- Follow-up scans on days 10-14 for distal DVT cases to assess propagation.
Main Results:
- Distal DVT was detected in 1/22 THR patients and 9/58 TKR patients.
- All identified DVTs were asymptomatic.
- No proximal propagation of distal DVTs was observed on follow-up scans.
- No postthrombotic symptoms were reported during an 18-month follow-up.
Conclusions:
- Isolated distal DVT is a frequent, yet clinically silent, finding in low-risk Chinese patients post-THR or TKR.
- Duplex ultrasonography monitoring may be a valuable alternative to routine anticoagulation in selected populations.
- Asymptomatic distal DVTs in this cohort did not appear to lead to adverse long-term outcomes.