Objective: To determine the prevalence of venous thromboembolism (VTE) after total hip replacement (THR), total knee replacement (TKR) or bilateral TKR in a large sample of patients in a major hospital orthopaedic unit. Design, setting and patients: The Mater Misericordiae Hospital, North Sydney, NSW, a 195‐bed private hospital. All patients who had THR, TKR or bilateral TKR at the hospital between 1 April 1995 and 31 December 2001 had physical prophylaxis (graduated compression elastic stockings or intermittent pneumatic compression, or both) and chemical prophylaxis (anticoagulant) against VTE. All underwent ultrasonography of both legs before discharge, with a small, symptomatic group also undergoing a ventilation/perfusion lung scan (V/Q scan) and computed tomographic pulmonary angiography. Main outcome measures: Prevalence of deep‐vein thrombosis (DVT) and symptomatic pulmonary embolism (PE) before discharge. Results: Among a total of 5999 patients, the pre‐discharge prevalence of DVT after THR, TKR or bilateral TKR was 8.9%, 25.6% and 36.9%, respectively. The prevalence of symptomatic non‐fatal in‐hospital PE was 1.9%, while the prevalence of fatal in‐hospital PE was 0.05%. Conclusions: Despite short‐term chemical and physical thromboprophylaxis, the prevalence of DVT after lower‐limb joint replacement, measured by pre‐discharge ultrasonography, was high. The rate of symptomatic non‐fatal in‐hospital PE was moderate, but fatal in‐hospital PE was rare.

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Congenital cataracts can cause irreversible loss of sight unless surgery is performed soon after birth. In the case reported here an obstetric ultrasound detected congenital cataracts in an otherwise normal fetus without any history of familial syndrome, infection or metabolic disorder. The lens opacity was detectable on transabdominal ultrasound at 18 weeks' gestation and the appearance was unchanged near-term. An otherwise normal boy was delivered at term and underwent surgery in the first week of life. Prenatal detection of the cataracts by means of high quality obstetric ultrasound facilitated early surgery and preservation of sight. (MJA 1998; 169: 385-386)

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