Why the study?
Does duplex scanning accurately diagnose proximal DVT compared to venography in total hip arthroplasty patients?
Does duplex scanning accurately diagnose proximal DVT compared to venography in total hip arthroplasty patients?
Duplex scanning is an effective, noninvasive method with high specificity and accuracy for screening proximal DVT in postoperative total hip arthroplasty patients.
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Supports duplex scanning as a specific noninvasive screen for proximal DVT post-arthroplasty; leaves open need for prospective validation of sensitivity.
Combined B-mode/Doppler (duplex) scanning and venography were compared in routine perioperative screening for proximal deep vein thrombosis (DVT) in 158 total hip arthroplasty (THA) patients. Preoperative scans were performed in the first 60 patients; the low preoperative prevalence of 2% for proximal DVT was thought not to warrant routine preoperative scanning. Postoperatively, duplex scanning had a sensitivity of 79%, a specificity of 98%, and an accuracy of 97% when venography was considered as the gold standard. The postoperative incidence of proximal DVT was 12% in this group of THA patients treated with mechanical and pharmacologic prophylaxis. Including calf vein thrombosis, 30% had DVT postoperatively. This study demonstrates the efficacy of duplex scanning for diagnosing proximal DVT and describes an effective noninvasive method of screening THA patients for the presence of proximal DVT.
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Barnes et al. (1991) studied this question.
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