Postphlebitic syndrome after hip arthroplasty: 43 patients followed at least 5 years

McNally, Martin; McAlinden, M. Gavan; O’Connell, Barry M.; Mollan, R. A. B.

doi:10.3109/17453679408994611

Cited by 27 publications

(12 citation statements)

References 16 publications

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“…This fairly low overall frequency is similar to that found by Ginsberg et al (2000) after THA, TKA, or hip fracture. It is considerably lower than the 13-26% reported by other investigators in the era before routine thromboprophylaxis (McNally et al 1994, Siragusa et al 1997, Deehan et al 2001 (Table 1).…”

Section: Discussioncontrasting

confidence: 49%

“…Secondly, all of our subjects, and most of those reported by Ginsberg et al (2000), received perioperative thromboprophylaxis. By contrast, in studies reporting higher frequencies of postoperative PTS (McNally et al 1994, Siragusa et al 1997, Deehan et al 2001), use of thromboprophylaxis was low-occurring in only 2% of patients in one study (Deehan et al 2001), and probably not at all in another study (McNally et al 1994). Thirdly, different methods have been used to ascertain and define PTS, which could possibly affect the reported rates of PTS.…”

Section: Discussionmentioning

confidence: 71%

“…The syndrome is usually apparent within 1-2 years (Prandoni et al 1996, Ginsberg et al 2001, Kahn and Ginsberg 2002. The reported overall prevalences of PTS after major lower limb arthroplasty vary widely, from < 5% to 26%, and in those with DVT, from 5% to 89% (McNally et al 1994, Siragusa et al 1997, Ginsberg et al 2000, Deehan et al 2001 (Table 1). Although arthroplasty is now a common procedure, and the high risk of postoperative DVTs is well-recognized, there has been only one prospective cohort study published with more than 100 subjects assessed for PTS following THA.…”

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confidence: 99%

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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: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 71%

mentioning

confidence: 99%

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Post-thrombotic syndrome after total hip arthroplasty is uncommon

et al. 2008

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“…Fondaparinux is a new drug and it is important to have information about the cost-effectiveness as basis for decisions about pricing,reimbursement,and use of this drug. the probability of clinical VTE following HFS was estimated at 70% greater than that following hip replacement [2,18,19,30,31]. This estimate was consistent with the clinical VTE rates seen between HFS and THR in the Pulmonary Embolism Prevention study [32].…”

Section: Stockholm School Of Economicsstockholmswedenmentioning

confidence: 95%

Cost-effectiveness of fondaparinux vs. enoxaparin as venous thromboembolism prophylaxis in Sweden

Lundkvist¹,

Bergqvist

2003

The European Journal of Health Economics

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Deep-vein thrombosis and pulmonary embolism are important causes of morbidity and mortality among patients undergoing major surgery. Fondaparinux is a new antithrombotic agent for use in prophylaxis, and this study compared its cost and effect vs. enoxaparin as prophylactic treatment in patients undergoing total knee replacement, total hip replacement, or hip-fracture surgery in Sweden. The analyses were based on a simulation model. Swedish data on cost for deep-vein thrombosis and pulmonary embolism were obtained from a large sample of patients undergoing major orthopedic surgery. The relative risk reduction for treatment with fondaparinux was estimated from results of four recently published clinical trials. The base case analyses showed that fondaparinux was cost saving and more effective than enoxaparin after total knee replacement and hip-fracture surgery and had costs per prevented venous thromboembolism of about 239 after total hip replacement. Fondaparinux is thus more cost-effective than enoxaparin as prophylactic treatment in patients undergoing major surgery in Sweden.

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“…However, in a small study, postthrombotic syndrome has been found to develop after subclinical DVT in a high percentage of hip-operated patients (McNally et al 1994). Additional studies on that topic would be of great interest.…”

Section: Throm Boem Bolism-an Academic Concern or A Clinical Reality?mentioning

confidence: 99%

Commentaries on thromboprophylaxis in hip replacement surgery: Thromboembolism–An academic concern or a clinical reality?

1999

Acta Orthopaedica Scandinavica

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Postphlebitic syndrome after hip arthroplasty: 43 patients followed at least 5 years

Cited by 27 publications

References 16 publications

Post-thrombotic syndrome after total hip arthroplasty is uncommon

Post-thrombotic syndrome after total hip arthroplasty is uncommon

Cost-effectiveness of fondaparinux vs. enoxaparin as venous thromboembolism prophylaxis in Sweden

Commentaries on thromboprophylaxis in hip replacement surgery: Thromboembolism–An academic concern or a clinical reality?

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