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. 2020 Feb 12;21(1):95.
doi: 10.1186/s12891-020-3100-4.

Venous thromboembolism rates after hip and knee arthroplasty and hip fractures

Viswanath Mula  1 , Sunny Parikh  2 , Sivakolundu Suresh  1 , Alex Bottle  3 , Mark Loeffler  1 , Mahbub Alam  1
Affiliations

Venous thromboembolism rates after hip and knee arthroplasty and hip fractures

Viswanath Mula et al. BMC Musculoskelet Disord. .

Abstract

Background: The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates following Total Hip (THA), Total Knee Arthroplasty (TKA) and surgery for hip fractures (NOF#).

Methods: Over 3 years, all patients investigated for VTE were analysed using Picture Archiving Communications System (PACS). All positive scans were then cross-referenced using PACS and local registry data to see if they had undergone THA, TKA or NOF# in the preceding 90 days. Mortality data were obtained from the national administrative database, Hospital Episode Statistics.

Results: Five thousand seven hundred eighty-eight patients underwent investigation for VTE and there were 29 diagnoses of PE and 24 of DVT. There was a 0.77% rate of symptomatic DVT after THA, 0.05% after TKA and 0.55% after NOF #. The rate of confirmed symptomatic PE for THA was 0.46, 0.27% for TKA and 0.96% for NOF #. Mortality at one-year post-THA was 0.6, 0.6% for TKA and 25.9% after NOF#. All patients contacted either remained within the catchment area for the minimum 90 postoperative days or died within the catchment area.

Conclusions: The 90 day post-operative prevalence of symptomatic VTE of 1.2, 0.3 and 1.5% in THA, TKA and NOF # respectively are similar to other studies using symptomatic and imaging positive VTE as their endpoint. The study uses a method of collecting data which can be utilised in centres where PACS is available.

Keywords: Hip fractures; PACS; THA; TKA; VTE.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A flow chart explaining the sequence for calculating the rate of postoperative 90 day VTE. The blue boxes show the 3 stages in the collection of data to calculate the VTE rates. The 2 white boxes show how the method was validated
See this image and copyright information in PMC

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