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Does total hip arthroplasty predispose to chronic venous insufficiency?
The Journal of Arthroplasty
|August 1, 1996
Summary
Deep vein thrombosis (DVT) is common after total hip arthroplasty, but long-term studies show it rarely causes chronic venous insufficiency. Most patients with prior DVT experienced no significant venous issues years later.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
- Medical Imaging
Background:
- Total hip arthroplasty (THA) is a common procedure associated with a risk of deep vein thrombosis (DVT).
- The long-term sequelae of post-operative DVT following THA, specifically chronic venous insufficiency (CVI), are not well-established.
Purpose of the Study:
- To investigate the long-term incidence of symptomatic chronic venous insufficiency (CVI) in patients who underwent total hip arthroplasty (THA).
- To determine the relationship between diagnosed deep vein thrombosis (DVT) after THA and the development of CVI years later.
Main Methods:
- A retrospective review of 134 limbs (40% retrieval rate) 14-21 years post-THA.
- Deep vein thrombosis (DVT) was screened using the fibrinogen uptake test and confirmed venographically.
- Chronic venous insufficiency (CVI) was assessed using clinical grading and photoplethysmography.
Main Results:
- Clinical CVI was present in 12% of limbs without prior DVT and 11% with prior DVT (P = .77).
- CVI incidence varied by thrombus location: 9% for calf, 0% for isolated femoral, and 25% for combined calf and femoral.
- Photoplethysmography identified only 2% of cases as attributable to post-THA DVT.
Conclusions:
- Despite a high incidence of DVT detected post-THA, symptomatic chronic venous insufficiency is an uncommon long-term outcome.
- The development of CVI after THA appears to be infrequent, even in patients with confirmed DVT.