There is a high prevalence of DVT detected by routine venography after total knee (66%) and hip (32%) replacement without prophylaxis, though short-term symptomatic thromboembolic events and related mortality appear low.
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High asymptomatic DVT rates post-arthroplasty without prophylaxis should not alter practice; leaves open optimal screening and prophylaxis strategies.
We performed routine venography after operation in a consecutive series of 252 patients with total joint arthroplasties in whom no form of routine chemical or mechanical prophylaxis had been used. The prevalence of deep-vein thrombosis (DVT) was 32% (16% distal, 16% proximal) after total hip replacement and 66% (50% distal, 16% proximal) after total knee replacement (p < 0.001). We did not treat distal DVT. There were only two readmissions within three months of surgery because of thromboembolic disease. There were two deaths within this period, neither of which was due to pulmonary embolism.
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Clarke et al. (1997) studied this question.
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