title: Occurrence of pulmonary thromboembolism immediately after arthroplasty.
abstract: BACKGROUND
  Respiratory complications are common after arthroplasty, with pulmonary thromboembolic disease (PTE) and fat emboli being the most serious. A scintigraphic study was designed to assess the occurrence of both diseases. A prospective tomographic study of perfusion was performed within 24 h of arthroplasty. Details of the detection of fat embolism will be presented elsewhere.
  
  
  METHODS
  Patients with previous PTE were excluded. Tomographic lung studies were acquired after 99mTc-macroaggregated albumin injection. Pre- and post-operative arterial blood gases (ABGs) and relevant chest radiography/computed tomography scans were obtained. ABGs were analysed as the difference in alveolar-arterial oxygen gradients, pre- and post-operatively (DA-a).
  
  
  RESULTS
  Forty patients were studied (16F, 24M) with a mean age of 71 years (range 36-88 years). Of these, 16 were hip and 24 knee arthroplasties. PTE was detected in 25 of 38 (66%) patients evaluated. The value of DA-a was significantly different between patients with PTE and without PTE (P>0.05). Administration of prophylactic pre-operative low molecular weight heparin makes no difference to the early onset of PTE.
  
  
  CONCLUSIONS
  There is a high incidence of PTE immediately after arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Concord Hospital, Sydney, Australia.
authors.forename: W
authors.initials: W
authors.lastname: Bruce
authors.forename: H
authors.initials: H
authors.lastname: Van der Wall
authors.forename: M
authors.initials: M
authors.lastname: Peters
authors.forename: Y
authors.initials: Y
authors.lastname: Liaw
authors.forename: L
authors.initials: L
authors.lastname: Morgan
authors.forename: G
authors.initials: G
authors.lastname: Storey
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin