Does total hip arthroplasty predispose to chronic venous insufficiency?

Warwick, David; Perez, Joseph; Vickery, Christopher; Bannister, Gordon

doi:10.1016/s0883-5403(96)80105-7

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…However, it is unlikely that all of the 4-13% of patients previously reported as developing PTS-with no early DVT detected (Table 1)-had such DVTs as the immediate cause of their PTS symptomatology. As did we, others have also noted symptoms and/or signs of PTS after surgery in substantial numbers of patients or limbs with no documented DVT (Browse et al 1980, Andersen and Wille-Jorgensen 1991, Warwick et al 1996, Ginsberg et al 2000. Other causes of PTS symptoms in patients who have undergone arthroplasty might include more advanced age, relative immobility, other co-morbidities (including previous venous thromboembolism or chronic venous insuf- ficiency), and the sequelae of surgery itself (Ginsberg et al 2000).…”

Section: Discussionsupporting

confidence: 57%

Post-thrombotic syndrome after total hip arthroplasty is uncommon

et al. 2008

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Background Deep vein thrombosis (DVT), usually asymptomatic, is common after total hip arthroplasty (THA). Post-thrombotic syndrome (PTS) is a potential late complication of DVT, but there is limited data on its occurrence.Patients and methods This was a prospective cohort study of subjects at one hospital who had participated in a trial of thromboprophylaxis for THA and who had postoperative venography. Data were collected at baseline and 2-4 years later to ascertain symptoms of PTS using a modification of a validated scoring system. Outcomes were collected without knowledge of baseline characteristics or venogram results. Potential predictors of PTS were explored using exact logistic regression analyses.Results The cohort (n = 188) had a mean age of 63 years, 51% were male, 35% had a BMI of > 30, and 4% had a prior history of DVT. 25 patients (13%) had DVTs on venography. 12 patients (6%, 95% CI: 3-11) subsequently developed symptoms consistent with PTS, 7 with bilateral symptoms. Most affected limbs (15 of 19) had no postoperative DVT. No statistically significant predictors of PTS were found.Interpretation Symptoms of PTS are infrequent after THA in patients who receive some form of thromboprophylaxis. Our findings, which are consistent with the existing literature, suggest that there is a potential benefit to giving thromboprophylaxis for reduction of symptomatic PTS.

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Section: Discussionsupporting

confidence: 57%

Post-thrombotic syndrome after total hip arthroplasty is uncommon

et al. 2008

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“…The complications of THA result from biological or mechanical causes, 4 most commonly aseptic or septic loosening of the implant, neuropraxia, dislocation, and fracture 1 . Subclinical thromboembolic events frequently occur during and shortly after THA in humans and in dogs 5–8 . However, clinical manifestations of thrombosis, such as thromboembolic disease or obliteration of femoral blood flow are uncommon 5,7,9–12 .…”

mentioning

confidence: 99%

Femoral Medullary Infarction Secondary to Canine Total Hip Arthroplasty

2000

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“…No significant increase in risk of PTS was identified after asymptomatic proximal or distal DVT. Warwick et al [14] reviewed 134 (64 patients) limbs following THR between 14 and 21 years. 98 limbs were found to have a positive fibrinogen uptake test.…”

Section: Relevant Studies Related To Orthopaedic Surgerymentioning

confidence: 99%

Are We Missing Post-Thrombotic Syndrome Syndrome? An Orthopaedic Perspective in Lower Limb Arthroplasty

2012

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2–5% of patients undergoing hip or knee arthroplasty develop a symptomatic DVT; there is evidence to suggest that without prophylaxis 40–60% of patients have a subclinical DVT. This can be reduced by around half with appropriate thromboprophylaxis; there still remains a significant incidence of subclinical DVT. Therefore, it is important to know, as orthopaedic surgeons, if our patients undergoing large joint arthroplasty are being adversely affected. Post-thrombotic syndrome (PTS) is usually associated with symptomatic DVT, and the purpose of this paper is to address if asymptomatic DVT is also associated with an increased risk of PTS. The majority of evidence gathered does not support a link; therefore, there is no evidence to warrant a change in practice to warn patients of a potential risk or to routinely screen asymptomatic patients.

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Does total hip arthroplasty predispose to chronic venous insufficiency?

Cited by 17 publications

References 15 publications

Post-thrombotic syndrome after total hip arthroplasty is uncommon

Post-thrombotic syndrome after total hip arthroplasty is uncommon

Femoral Medullary Infarction Secondary to Canine Total Hip Arthroplasty

Are We Missing Post-Thrombotic Syndrome Syndrome? An Orthopaedic Perspective in Lower Limb Arthroplasty

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