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[Silent thrombosis and total hip endoprosthesis]
U Piontkowski1, H Höhndorf, K Freier
1Orthopädischen Klinik, Bezirkskrankenhauses, Frankfurt, Oder.
Beitrage Zur Orthopadie Und Traumatologie
|May 1, 1990
Summary
Preoperative screening for silent thrombosis using phlebography in total hip replacement patients showed a small reduction in post-operative complications. This invasive method is not recommended for general screening but may be useful for high-risk individuals.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
- Diagnostic Imaging
Background:
- Total hip replacement (THR) is a common orthopedic procedure.
- Postoperative thromboembolism remains a significant complication.
- Prevalence of asymptomatic deep vein thrombosis (DVT) prior to THR is not well-established.
Purpose of the Study:
- To investigate the incidence of "silent thrombosis" (asymptomatic DVT) in patients undergoing THR.
- To evaluate the effectiveness of preoperative unilateral phlebography in identifying these cases.
- To assess the impact of postponing surgery on reducing postoperative thromboembolic complications.
Main Methods:
- Preoperative unilateral phlebography of the leg was performed on 168 patients scheduled for THR.
- Patients diagnosed with silent thrombosis had their surgeries postponed.
- Postoperative complication rates were compared between groups.
Main Results:
- Silent thrombosis was detected in 8 out of 168 patients (approximately 4.8%).
- Postponing surgery for these patients resulted in only a minor decrease in postoperative thromboembolic complications.
- The invasive nature and limited impact suggest limitations for widespread screening.
Conclusions:
- Preoperative phlebography for silent thrombosis is not recommended as a routine screening tool for all THR patients due to its invasiveness and minimal benefit in reducing overall complications.
- The method may be considered for a modified approach in carefully selected high-risk patient populations.
- Further research into less invasive screening methods for DVT in THR candidates is warranted.