Incidence of Posthospitalization Proximal Deep Venous Thrombosis After Total Hip Arthroplasty A Pilot Study

Incidence and Time Course of Thromboembolic Outcomes Following Total Hip or Knee Arthroplasty

“…Our findings certainly support the widely held belief that posthospitalization thromboembolism is an important clinical problem. 11,15,16 The results of our survey of California orthopedic surgeons make it unlikely that the high rate of posthospitalization thromboembolism, particularly after total hip arthroplasty, was due to inadequate use of thromboprophylaxis after surgery. Respondents indicated that approximately 88% of the cases that underwent hip or knee arthroplasty received 1 or more of the prophylaxis regimens that were recommended between 1991 and 1993, namely subcutaneous heparin, pneumatic compression, or oral warfarin.…”

“…30 The results of our questionnaire indicated that thromboprophylaxis regimens used after hip and knee arthroplasty were almost identical, suggesting that the observed difference in the temporal pattern of thromboembolic outcomes after total hip and total knee arthroplasty was not due to a difference in the frequency, type, or duration of thromboprophylaxis. Indeed, concerns expressed in the orthopedic literature regarding posthospitalization thromboembolism have focused primarily on hip arthroplasty, 11,16 making it likely that any difference in the frequency of posthospital discharge thromboprophylaxis would have favored greater use among the total hip arthroplasty cases. Such a bias should have led to a lower incidence of thromboembolism after hospital discharge among hip arthroplasty cases.…”

“…A number of studies have provided evidence that asymptomatic venous thromboembolism develops in a significant proportion of patients after hospital discharge after either general or orthopedic surgery. [8][9][10][11][12][13][14][15][16] Moreover, recent clinical trials have demonstrated that more prolonged medical prophylaxis after hospital discharge significantly reduces the incidence of venographically detected DVT after total hip arthroplasty. 17,18 The objectives of this study were to determine the incidence and time course of clinically overt DVT and PE after unilateral total hip or knee arthroplasty using a large linked hospital discharge data set.…”

Prolonged Prophylaxis with Unfractioned Heparin Is Effective to Reduce Delayed Deep Vein Thrombosis in Total Hip Replacement

“…Recent data suggest the persistence of the risk after hospital disThis work was supported in part by funds from the National Research Council, Cardiorespiratory Group, and the Italian Ministry of University and Scientific and Technologic Research. charge [2][3][4][5] and the delayed risk is perhaps higher than that estimated on clinical ground only [6]. In spite of that, pharmacological prophylaxis is commonly discontinued at the moment of discharge from hospital [7][8][9][10][11][12][13].…”

Prolonged prophylaxis against postoperative venous thromboembolism

“…One rea son could be that the patients are immobilized at home. Recent studies in both general sur gical and hip arthroplasty patients have pointed in the same direction [35,36,37]. Prolonged immobilization is an important risk factor concerning development of DVT in the population [38].…”