March 13, 2000
View Full PaperPostthrombotic Syndrome After Hip or Knee Arthroplasty
Key Result
Symptomatic postthrombotic syndrome occurred at low and similar rates 2 to 7 years after major joint arthroplasty among patients with proximal DVT (4.0%), distal DVT (6.1%), and no DVT (4.3%).
Study Design
Type
Cross-Sectional (n=255)
Multicenter
Yes
Structured PICO
Does the development of DVT after major hip or knee arthroplasty increase the risk of symptomatic postthrombotic syndrome?
P
Population
255 subjects who had undergone major hip or knee arthroplasty 2 to 7 years previously and had routine predischarge venography showing proximal DVT (n=25), distal DVT (n=66), or no DVT (n=164).
I
Intervention
Proximal or distal deep vein thrombosis (DVT) after major hip or knee arthroplasty (treated with 6 to 12 weeks of anticoagulant therapy)
C
Comparator
No DVT after major hip or knee arthroplasty
O
Outcome
Presence of symptomatic postthrombotic syndrome (PTS) confirmed by objectively confirmed venous valvular incompetencehard clinical
Symptomatic postthrombotic syndrome is uncommon after major hip or knee arthroplasty, and its incidence is not significantly increased in patients who develop postoperative DVT and receive standard anticoagulant therapy.
Main Result
Absolute Event Rate: 4% vs 4.3%
Abstract
BACKGROUND: Although the incidence of the postthrombotic syndrome (PTS) has been addressed in patients with symptomatic deep vein thrombosis (DVT), less information is available on the incidence in patients who develop asymptomatic DVT after major hip or knee arthroplasty. OBJECTIVES: To determine whether symptomatic PTS occurs more frequently in patients who develop DVT after hip or knee arthroplasty than those who are free of DVT and to provide an estimate of the incidence of PTS in patients who had undergone major hip or knee arthroplasty and had proximal DVT, distal (calf) DVT, or no DVT. DESIGN AND SETTING: A cross-sectional study conducted at the Hamilton Health Sciences Corporation, Hamilton, Ontario, and the Academic Medical Centre, Amsterdam, the Netherlands. SUBJECTS AND METHODS: Two hundred fifty-five subjects who had undergone major hip or knee arthroplasty 2 to 7 years previously and had routine predischarge venography showing proximal DVT (n = 25), distal DVT (n = 66), or no DVT (n = 164) were enrolled from March 1993 through December 1998. The presence of symptomatic PTS confirmed by the presence of objectively confirmed venous valvular incompetence was ascertained. RESULTS: The rates of PTS were low and not significantly different among the 3 subgroups: 1 (4.0%, 95% confidence interval CI = 0.1%-20.4%) of 25 patients with proximal DVT, 4 (6.1%, 95% CI = 1.7%-14.8%) of 66 patients with distal DVT, and 7 (4.3%, 95% CI = 1.7%-8.6%) of 164 patients with no DVT. CONCLUSIONS: Symptomatic PTS is an uncommon complaint after major hip or knee arthroplasty. Patients who develop postoperative proximal or distal DVT and who receive 6 to 12 weeks of anticoagulant therapy are not predisposed to PTS.
Cite This Study
Ginsberg et al. (Mon,) conducted a cross-sectional in Postthrombotic syndrome after hip or knee arthroplasty (n=255). Proximal or distal DVT vs. No DVT was evaluated on Symptomatic postthrombotic syndrome confirmed by venous valvular incompetence. Symptomatic postthrombotic syndrome occurred at low and similar rates 2 to 7 years after major joint arthroplasty among patients with proximal DVT (4.0%), distal DVT (6.1%), and no DVT (4.3%).