Orthopedic Research and Reviews (Nov 2023)

Incidence and Distribution of Deep Vein Thrombosis Following Total Hip Arthroplasty Using an Anterolateral Supine Approach

  • Itou J,
  • Munakata Y,
  • Kuramitsu Y,
  • Madarame H,
  • Okazaki K

Journal volume & issue
Vol. Volume 15
pp. 199 – 205

Abstract

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Junya Itou, Yutaro Munakata, Yujiro Kuramitsu, Hiromi Madarame, Ken Okazaki Department of Orthopaedic Surgery, Tokyo Women’s Medical University, Tokyo, JapanCorrespondence: Ken Okazaki, Department of Orthopaedic Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan, Tel +81-3-3353-8111, Fax +81-3-5269-7618, Email [email protected]: Venous thromboembolism (VTE) is a potential major complication in patients undergoing total hip arthroplasty (THA). However, the incidence of VTE following THA using anterolateral supine approach (ALS) has not been reported. The purpose of this study was to investigate the incidence of perioperative VTE and the distribution and characteristics of deep vein thrombosis (DVT) following ALS THA.Patients and Methods: This retrospective single-arm study analyzed the 182 consecutive hips of 164 patients who underwent primary ALS THA. Pharmacological prophylaxis consisted of enoxaparin 20 mg twice daily for approximately 6 days starting 24 h postoperatively until duplex ultrasonography was performed to determine whether postoperative DVT was present. DVT was assessed by whole-leg Doppler ultrasound, and the location and characteristics of any thrombus were recorded. If pulmonary thromboembolism was suspected, contrast-enhanced computed tomography was performed.Results: The overall incidence of VTE was 9.9% for DVT (18/182 hips) and 0.5% for pulmonary thromboembolism (1/182 hips). Most DVTs were in the soleal vein on the affected side and showed isoechoic or hypoechoic echogenicity. All thrombi were non-floating.Conclusion: Following ALS THA with standard pharmacological prophylaxis and an early weight-bearing protocol, the incidence of perioperative DVT was approximately 10%, mostly occurring in the lower leg.Keywords: anterolateral supine approach, deep vein thrombosis, pulmonary thromboembolism, total hip arthroplasty, venous thromboembolism

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