Key result
Total hip replacement carries a ~51% incidence of DVT, frequently originating in the femoral vein.
Cohort (n=160)
Intraoperative distortion and almost total occlusion of the femoral vein during total hip replacement manipulation is a likely mechanism for the high incidence of primary femoral vein thrombosis in these patients.
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May inform intraoperative femoral vein protection during hip replacement; leaves open impact on postoperative DVT rates.
Of 160 patients who underwent total hip replacement, 81 developed venographic evidence of thrombi in the operated leg. In 46 cases (57%) the thrombus originated from the femoral vein, and in 43 of these the exact site of origin was defined by venography. In 34 cases (74%) the thrombus arose from the wall of the femoral vein at the level of the lesser trochanter. This region was studied by intraoperative venography in eight patients undergoing total hip replacement, and in every case severe distortion of the common femoral vein was observed, producing almost total occlusion. We suggest that intraoperative damage to the femoral vein results from manipulation of the leg, and that this is one reason why the operation is followed by a high incidence of deep vein thrombosis in the upper femoral region.
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Stamatakis et al. (1977) conducted a cohort in Deep vein thrombosis (n=160). Total hip replacement (intraoperative leg manipulation) was evaluated on Venographic evidence of thrombi in the operated leg. Among 160 patients undergoing total hip replacement, 81 (50.6%) developed deep vein thrombosis in the operated leg, frequently originating in the proximal femoral vein likely due to intraoperative vessel distortion.
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