title: Are we missing post-thrombotic syndrome syndrome? An orthopaedic perspective in lower limb arthroplasty.
abstract: 2-5% of patients undergoing hip or knee arthroplasty develop a symptomatic DVT; there is evidence to suggest that without prophylaxis 40-60% of patients have a subclinical DVT. This can be reduced by around half with appropriate thromboprophylaxis; there still remains a significant incidence of subclinical DVT. Therefore, it is important to know, as orthopaedic surgeons, if our patients undergoing large joint arthroplasty are being adversely affected. Post-thrombotic syndrome (PTS) is usually associated with symptomatic DVT, and the purpose of this paper is to address if asymptomatic DVT is also associated with an increased risk of PTS. The majority of evidence gathered does not support a link; therefore, there is no evidence to warrant a change in practice to warn patients of a potential risk or to routinely screen asymptomatic patients.
authors.affiliation: Trauma and Orthopaedic Unit, Ninewells Hospital, Dundee, UK.
authors.forename: M
authors.initials: M
authors.lastname: Reidy
authors.forename: A
authors.initials: A
authors.lastname: Macinnes
authors.forename: A
authors.initials: A
authors.lastname: Pillai
references.citation: Acta Orthop. 2008 Dec;79(6):794-9
references.pmid: 19085497
references.citation: Blood Rev. 2002 Sep;16(3):155-65
references.pmid: 12163001
references.citation: BMJ. 2009 Dec 03;339:b4583
references.pmid: 19959589
references.citation: Acta Orthop Scand. 2001 Feb;72(1):42-5
references.pmid: 11327412
references.citation: Arch Intern Med. 2000 Mar 13;160(5):669-72
references.pmid: 10724052
references.citation: Am J Orthop (Belle Mead NJ). 2006 Oct;35(10):469-72
references.pmid: 17131737
references.citation: Hematology Am Soc Hematol Educ Program. 2010;2010:216-20
references.pmid: 21239797
references.citation: Chest. 2004 Sep;126(3 Suppl):338S-400S
references.pmid: 15383478
references.citation: Br J Haematol. 2009 May;145(3):286-95
references.pmid: 19222476
references.citation: Instr Course Lect. 2011;60:283-90
references.pmid: 21553780
references.citation: J Thromb Haemost. 2009 May;7(5):884-8
references.pmid: 19320818
references.citation: Arch Intern Med. 2003 Jun 9;163(11):1362-6
references.pmid: 12796074
references.citation: Minerva Cardioangiol. 1997 Mar;45(3):57-66
references.pmid: 9213820
references.citation: J Arthroplasty. 1996 Aug;11(5):529-33
references.pmid: 8872571
references.citation: Acta Orthop Scand. 1994 Dec;65(6):595-8
references.pmid: 7839842