Incidence of venous thromboembolism in patients undergoing major hip surgeries at a single institution
Venous thoromboembolism (VTE) is one of the most significant complications after hip surgeries. A large number of studies have been reported about the incidence of VTE after total hip arthroplasties, and a small number of reports were found in the incidence of VTE concerning periacetabular osteotomy, revision total hip arthroplasties THA and surgery for hip fracture postoperatively. Furthermore, there exists no comparative study of the incidence of VTE among major hip surgeries at a single institution. We have reported the incidence of VTE among hip surgeries performed at Asahikawa Medical University, Japan.
A total of 820 Hip surgeries were performed in this institution. The procedures included 420 hips that underwent primary total hip arthroplasties (THA), 91 revision or removal of total hip arthroplasties (revision THA), 144 periacetabular osteotomy (PAO) and 165 surgery for hip fracture (SHF) between 2006 and 2012. After the operations, VTE was detected by multidetector computed tomography (MDCT) that scanned 768 cases and by ultrasound that scanned 52 cases postoperatively after 10-14 days. The overall incidence of VTE was 12.2%. The incidence of VTE after THA was 13.1%, Revision THA was 13.2%, PAO was 2.1% and SHF was 18.1%.
Routine screening with MDCT is controversial. MDCT is an invasive examination using contrast media in addition to radiation exposure. On patient who had an allergy to the contrast media or refused to be examined by MDCT, Ultrasound was performed for detecting VTE by an experienced radiologist. This study provides precise information by MDCT and Ultrasound on incidence for VTE in patients undergoing hip surgeries who were treated by almost the same protocol at a single institution. The results of this data indicate that the incidence of VTE after PAO is significantly lower than SHF and relatively lower than THA and Revision THA. Chemoprophylaxis therapy was effective especially on SHF patients.
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Reference: Yamanaka ,Y.; Ito.;H. (2016). Incidence of Venous Thromboembolism in Patients Undergoing Major Hip Surgeries at a Single Institution: A Prospective Study, Open Orthop. J., DOI: 10.2174/1874325001610010252
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