|
The Journal of Bone and Joint Surgery, Vol 76, Issue 3 341-348, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia
JR Lieberman, MM Huo, J Hanway, EA Salvati, TP Sculco and NE Sharrock
Hospital for Special Surgery, New York, NY 10021.
A prospective, randomized trial was done to evaluate the prevalence of deep
venous thrombosis following primary unilateral or bilateral total hip
arthroplasty with use of hypotensive epidural anesthesia, external
pneumatic-compression boots, and aspirin (Group I) and with use of
hypotensive epidural anesthesia and aspirin (Group II). All operations were
performed by two of us (E. A. S. and T. P. S.) through a posterolateral
approach. Two hundred and thirty-one patients who were more than
thirty-nine years old and who had a total of 250 primary total hip
arthroplasties were included in the study. There were 113 patients (124
hips) in Group I and 118 patients (126 hips) in Group II. All patients had
venography on the sixth, seventh, or eighth postoperative day. Group I had
no proximal thrombi, seven distal thrombi (6 per cent), and one late
pulmonary embolus (1 per cent). Group II had one proximal thrombus
(popliteal) (1 per cent), eight distal thrombi (6 per cent), and one late
pulmonary embolus (1 per cent). The difference was not significant (p =
0.65). However, a significant difference may have been noted if the study
population had been larger. The combination of hypotensive epidural
anesthesia and aspirin is effective prophylaxis against deep venous
thrombosis in patients who have a primary total hip arthroplasty. The
extremely low rate of deep venous thrombosis in the present study may be
attributed to the use of hypotensive epidural anesthesia and the associated
decrease in blood loss and transfusion requirements.(ABSTRACT TRUNCATED AT
250 WORDS)
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
J. R. Lieberman and W. K. Hsu
Prevention of Venous Thromboembolic Disease After Total Hip and Knee Arthroplasty
J. Bone Joint Surg. Am.,
September 1, 2005;
87(9):
2097 - 2112.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. H. Westrich, B. B. Weksler, C. J. Glueck, B. F. Blumenthal, and E. A. Salvati
Correlation of Thrombophilia and Hypofibrinolysis with Pulmonary Embolism Following Total Hip Arthroplasty: An Analysis of Genetic Factors
J. Bone Joint Surg. Am.,
December 9, 2002;
84(12):
2161 - 2167.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. G. Ryan, G. H. Westrich, H. G. Potter, N. Sharrock, L. M. Maun, W. Macaulay, P. Katkin, T. P. Sculco, and E. A. Salvati
Effect of Mechanical Compression on the Prevalence of Proximal Deep Venous Thrombosis as Assessed by Magnetic Resonance Venography
J. Bone Joint Surg. Am.,
November 12, 2002;
84(11):
1998 - 2004.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. P. Sculco, C. W. Colwell Jr., V. D. Pellegrini Jr., G. H. Westrich, and F. Bottner
Prophylaxis Against Venous Thromboembolic Disease in Patients Having a Total Hip or Knee Arthroplasty
J. Bone Joint Surg. Am.,
March 1, 2002;
84(3):
466 - 477.
[Full Text]
|
|
|
|
|
|
|
R. H. White, S. Gettner, J. M. Newman, K. B. Trauner, and P. S. Romano
Predictors of Rehospitalization for Symptomatic Venous Thromboembolism after Total Hip Arthroplasty
N. Engl. J. Med.,
December 14, 2000;
343(24):
1758 - 1764.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. B. Freedman, K. R. Brookenthal, R. H. Fitzgerald, S. Williams, and J. H. Lonner
A Meta-Analysis of Thromboembolic Prophylaxis Following Elective Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
July 1, 2000;
82(7):
929 - 929.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
E. A. SALVATI, V. D. PELLEGRINI, N. E. SHARROCK, P. A. LOTKE, D. W. MURRAY, H. POTTER, and G. H. WESTRICH
Symposium - Recent Advances in Venous Thromboembolic Prophylaxis During and After Total Hip Replacement
J. Bone Joint Surg. Am.,
February 1, 2000;
82(2):
252 - 70.
[Full Text]
|
|
|
|
|
|
|
J. A. HOOKER, P. F. LACHIEWICZ, and S. S. KELLEY
Efficacy of Prophylaxis Against Thromboembolism with Intermittent Pneumatic Compression After Primary and Revision Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
May 1, 1999;
81(5):
690 - 6.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
A. SARMIENTO and A. D. K. GOSWAMI
Thromboembolic Prophylaxis with Use of Aspirin, Exercise, and Graded Elastic Stockings or Intermittent Compression Devices in Patients Managed with Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
March 1, 1999;
81(3):
339 - 46.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. T. WOOLSON
Intermittent Pneumatic Compression Prophylaxis for Proximal Deep Venous Thrombosis after Total Hip Replacement
J. Bone Joint Surg. Am.,
November 1, 1996;
78(11):
1735 - 40.
[Abstract]
[Full Text]
|
|
|
|
