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Deep vein thrombosis after total hip replacement. A venographic study.

H E Høgevold¹, A Høiseth, O Reikerås

¹Department of Surgery, Ullevaal University Hospital, Oslo, Norway.

Acta Radiologica (Stockholm, Sweden : 1987)

|November 1, 1990

Summary

Asymptomatic deep vein thrombosis (DVT) is common after hip replacement, often resolving spontaneously. Early screening is crucial as these clots can dissolve within the first week post-surgery.

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Area of Science:

Vascular Surgery
Thrombosis Research
Orthopedic Surgery

Background:

Deep vein thrombosis (DVT) is a significant risk following total hip replacement.
Dextran thromboprophylaxis is commonly used, but its efficacy in preventing DVT requires ongoing evaluation.

Purpose of the Study:

To determine the incidence and characteristics of DVT in patients undergoing total hip replacement.
To assess the natural development and resolution of DVT during the early postoperative period.

Main Methods:

Venography was performed on postoperative day 2 in 62 patients and repeated on day 9 in 43 patients.
Patients received dextran for thromboprophylaxis.
Asymptomatic distal DVTs were not treated.

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Main Results:

Twenty-one patients (33.9%) had venographically confirmed DVT on postoperative day 2, with no clinical signs.
All DVTs were distal and equally distributed between legs.
Thrombolysis appeared to outpace thrombus formation between days 2 and 9, with spontaneous resolution observed.

Conclusions:

Distal, asymptomatic DVT is frequent after total hip replacement.
Spontaneous resolution of DVT can occur within the first postoperative week.
The timing of screening is critical for accurate DVT assessment and management decisions.