title: Are bilateral total joint arthroplasty patients at a higher risk of developing pulmonary embolism following total hip and knee surgery?
abstract: Despite developments in prophylactic methods, venous thromboembolism (VTE) continues to be a serious complication following total joint arthroplasty. The new AAOS/ACCP guidelines on preventing pulmonary embolism (PE) after total hip/knee arthroplasty (THA/TKA) do not make specific recommendations for bilateral vs. unilateral procedures. In-patient PE rates were examined for patients undergoing unilateral or simultaneous bilateral TKA/THA at our institution in 2011. Of the 7,437 THA/TKA surgeries completed at our institution in 2011, 36 patients suffered from PE (0.48%). The rate of PE for unilateral TKA was 0.61% vs. 1.87% for bilateral (P < 0.001) and for unilateral THA was 0.17% vs. 0.52% for bilateral THA. Despite patients being screened before being cleared to undergo bilateral THA/TKA, they remain at higher risk for VTE.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Yeager
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: Allison V
authors.initials: AV
authors.lastname: Ruel
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
keywords: bilateral; pulmonary embolism; total hip arthroplasty; total knee arthroplasty; venous thromboembolism