What is the clinical evidence from this study?

Study design: Observational. Population: Total hip arthroplasty (n=348). Intervention: Total hip arthroplasty. Primary outcome: Incidence of deep venous thrombosis (DVT) by postoperative day 21.

What question did this study set out to answer?

To determine the timing, anatomical distribution, and incidence of deep venous thrombosis before and after total hip arthroplasty.

January 1, 2022Juntendō Igaku/Juntendo igakuOpen Access

Appearance and Frequency of Deep Venous Thrombosis After Total Hip Arthroplasty

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Key result

Deep venous thrombosis was observed in 27.2% of patients by postoperative day 21 after total hip arthroplasty, with 66.6% of these cases occurring by postoperative day 1.

Why the study?

Methods and timing of examinations for deep venous thrombosis detection differ among facilities, though early detection is important to prevent pulmonary embolism after total hip arthroplasty.

Population

348 patients who underwent THA at a single hospital

Design

Single-center observational study

Follow-up

Postoperative day 21

Authors

KNKOJI NAMIKIJuntendo University MNMasahiko NozawaUniversity of Tokyo Health Sciences SKSUNG-GON KIMJuntendo University Nerima Hospital

Discussion

Member takes

Implication

May warrant early ultrasound evaluation after THA; leaves open effects on outcomes in prospective trials.

Key Points

To determine the timing, anatomical distribution, and incidence of deep venous thrombosis before and after total hip arthroplasty.
Evaluated 348 patients who underwent total hip arthroplasty at a single institution between April 2017 and April 2019, recording baseline demographics and perioperative variables.
Conducted blood tests and serial vascular ultrasonography examinations preoperatively and on postoperative days 0, 1, 3, 7, 14, and 21 to detect thrombus formation.
Deep venous thrombosis developed primarily in the soleal vein (74.7%), with no significant difference in occurrence between the operated and non-operated lower limbs.
Among thrombus-positive patients, clot detection peaked early: 13.3% preoperatively, 20.0% on POD 0, 46.7% on POD 1, 13.3% on POD 3, 6.7% on POD 7, and 0% on POD 14 and 21, resulting in 66.6% formed by POD 1 and 100% by POD 7.

Study Design

Type

Observational (n=348)

Multicenter

Structured PICO

Population

348 patients undergoing total hip arthroplasty, free of prior venous thromboembolism and preoperative anticoagulants, followed for 21 days postoperatively to assess DVT occurrence.

Exposure

All patients received enoxaparin 2,000 units twice a day for two weeks and an intermittent pneumatic compression device during the perioperative period for thromboprophylaxis.

Outcome

Time, site, and frequency of deep venous thrombosis (DVT) occurrence up to postoperative day 21, assessed by whole-leg vascular ultrasonography.safety

Deep venous thrombosis occurs very early after total hip arthroplasty, with the majority of cases forming by postoperative day 1 and all by day 7, highlighting the need for early ultrasound screening.

Limitations

Ultrasonography was performed by one person, preventing accurate calculation of inter-rater reliability.
Sensitivity of ultrasonography is low for distal-type DVT, potentially underestimating the true incidence.
Intraoperative factors such as duration of vein occlusion and limb position were not examined.
Ultrasonography was performed by one person, so inter-rater reliability cannot be calculated accurately.

Cite This Study

NAMIKI et al. (2022) conducted an observational in Total hip arthroplasty (n=348). Total hip arthroplasty was evaluated on Incidence of deep venous thrombosis (DVT) by postoperative day 21. Deep venous thrombosis was observed in 27.2% of patients by postoperative day 21 after total hip arthroplasty, with 66.6% of these cases occurring by postoperative day 1.

synapsesocial.com/papers/6a88564ff6c5aff6584fd245 https://doi.org/10.14789/jmj.jmj21-0056-oa

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Appearance and Frequency of Deep Venous Thrombosis After Total Hip Arthroplasty

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Appearance and Frequency of Deep Venous Thrombosis After Total Hip Arthroplasty

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

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