Deep vein thrombosis after total hip arthroplasty in Korean patients and D-dimer as a screening tool.
BACKGROUND
This prospective study was designed to confirm risk factors and to assess the incidence of deep vein thrombosis after total hip and surface replacement arthroplasty in Korean patients not receiving anticoagulation prophylaxis and to determine efficacy of plasma D-dimer levels as a screening test.


METHODS
From May 2003 to August 2004, 221 consecutive patients undergoing unilateral total hip arthroplasty and hip resurfacing were evaluated. All patients underwent ultrasonography preoperatively and venography and/or ultrasonography on postoperative day 7. Plasma D-dimer levels were estimated by latex immuno-assay preoperatively and on days 3 and 7 postoperatively.


RESULTS
Of the 221 patients in our cohort, 23 developed deep vein thrombosis (10.4%). Age (r = 0.245, P < 0.001) and gender (r = 0.155, P = 0.021) significantly correlated with deep vein thrombosis. Rise in incidence paralleled increase in age (X(2) = 32.860, P < 0.001). D-dimer levels on postoperative days 3 (gamma = 0.364, P < 0.001) and 7 (gamma = 0.470, P < 0.001) were significantly correlated to the development of DVT.


CONCLUSIONS
While incidence of deep vein thrombosis in Korean population after THA was lower than that in the West; it increased with age, and in female gender. Significant correlation was found between D-dimer levels and the development of deep vein thrombosis.
Yoo
Myung-Chul
MC
Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University East-West Neo Medical Center, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, South Korea.
Cho
Yoon-Je
YJ
Ghanem
Elie
E
Ramteke
Alankar
A
Kim
Kang-Il
KI
D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007723:Korea; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D