title: Does previous varicose vein surgery alter deep vein thrombosis risk after lower limb arthroplasty?
abstract: OBJECTIVE
  To determine the rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) after total knee arthroplasty (TKA) and total hip arthroplasty (THA) in patients who have had previous varicose vein (VV) surgery.
  
  
  METHODS
  Data on 57,364 patients who had undergone THAs and 51,859 patients who had undergone TKAs were obtained from the Scottish Arthroplasty Project and cross-referenced with patients for whom DVT/PE events had been recorded (Scottish Morbidity Database).
  
  
  RESULTS
  The THA DVT rate in patients who had previously undergone VV surgery was 0.8% (27/3478), and in those with no previous VV diagnosis or surgery was 0.8% (428/53,659). In patients with a previous VV diagnosis but no VV surgery, the THA DVT rate was 3.1% (7/227) (Pearson χ2 test, χ2 = 14.8, degrees of freedom = 2, P = 0.001). No significant difference was found for the corresponding data in the TKA cohort. The THA PE rate in patients who had previously undergone VV surgery was 0.7% (26/3478), and in those with no previous VV diagnosis or surgery 0.7% (376/53,659). No correlation was found between prior VV interventions and PE rates.
  
  
  CONCLUSIONS
  Untreated VVs are associated with an increased risk of DVT after THA. Therefore, patients with VVs should consider having them treated prior to undergoing orthopedic interventions.
authors.affiliation: Center for Translational Injury Research, Houston, Texas, USA.
authors.forename: Anahita
authors.initials: A
authors.lastname: Dua
authors.forename: Santiago
authors.initials: S
authors.lastname: Neiva
authors.forename: Alasdair
authors.initials: A
authors.lastname: Sutherland
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D024162:Second-Look Surgery; D014648:Varicose Veins / Q000453:epidemiology / Q000601:surgery*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*