The prevalence of venous thromboembolism after hip and knee replacement surgery.
OBJECTIVE
To determine the prevalence of venous thromboembolism (VTE) after total hip replacement (THR), total knee replacement (TKR) or bilateral TKR in a large sample of patients in a major hospital orthopaedic unit.


METHODS
The Mater Misericordiae Hospital, North Sydney, NSW, a 195-bed private hospital. All patients who had THR, TKR or bilateral TKR at the hospital between 1 April 1995 and 31 December 2001 had physical prophylaxis (graduated compression elastic stockings or intermittent pneumatic compression, or both) and chemical prophylaxis (anticoagulant) against VTE. All underwent ultrasonography of both legs before discharge, with a small, symptomatic group also undergoing a ventilation/perfusion lung scan (V/Q scan) and computed tomographic pulmonary angiography.


METHODS
Prevalence of deep-vein thrombosis (DVT) and symptomatic pulmonary embolism (PE) before discharge.


RESULTS
Among a total of 5999 patients, the pre-discharge prevalence of DVT after THR, TKR or bilateral TKR was 8.9%, 25.6% and 36.9%, respectively. The prevalence of symptomatic non-fatal in-hospital PE was 1.9%, while the prevalence of fatal in-hospital PE was 0.05%.


CONCLUSIONS
Despite short-term chemical and physical thromboprophylaxis, the prevalence of DVT after lower-limb joint replacement, measured by pre-discharge ultrasonography, was high. The rate of symptomatic non-fatal in-hospital PE was moderate, but fatal in-hospital PE was rare.
O'Reilly
Richard F
RF
Department of Medicine, Mater Misericordiae Hospital, North Sydney, NSW. roreilly@bigpond.net.au
Burgess
Ian A
IA
Zicat
Bernard
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D015995:Prevalence; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology