Proximal deep venous thrombosis and pulmonary embolus following total joint arthroplasty.
It has been proposed that prevention of deep venous thrombosis (DVT) will lead to a reduction in pulmonary embolism (PE). This retrospective comparative study examines the association between symptomatic proximal DVT (occurring at or proximal to the popliteal fossa) and PE in total joint arthroplasty (TJA) patients. We evaluated 1031 patients with DVT symptoms and 428 with PE symptoms. A total of 227 patients were evaluated for both. No statistically significant association found between developing PE and DVT within 90 days after TJA (P=0.94). Our findings raise into question the mechanical propagation theory. Formation of DVT and PE may be independent events in patients undergoing TJA. Evaluating the efficacy of thromboprophylaxis using DVT as end point may not reflect its efficacy for prevention of PE.
Orthopaedic Surgery at the Rothman Institute, Thomas Jefferson University, Hospital, Philadelphia, Pennsylvania.
Javad
J
Parvizi
Orthopaedic Research at the Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Raviinder
R
Parmar
Orthopaedic Research at the Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Ibrahim J
IJ
Raphael
Orthopaedic Research at the Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Camilo
C
Restrepo
Orthopaedic Surgery at the Rothman Institute, Thomas Jefferson University, Hospital, Philadelphia, Pennsylvania.
Richard H
RH
Rothman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014111:Tourniquets / Q000009:adverse effects; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants
athroplasty; clot; deep venous thrombosis; orthopedic; pulmonary embolism