Abstract:

BACKGROUND: It is rarely reported that the occurrence of deep venous thromboembolism after artificial hip replacement in the patients group which is strictly complied with “China’s major orthopedic surgery venous thromboembolism prevention guidelines” for thromboprophylaxis.
OBJECTIVE: To investigate the morbidity of deep venous thrombosis (DVT) in patients who underwent artificial hip replacement for standard prophylactic anticoagulant therapy.
METHODS: The data of patients who underwent artificial hip replacement from Department of Orthopedics, Peking Union Medical College Hospital were selected. Then patients who occurred DVT after replacement were retrospective analyzed involving the risk factors, preventive measures, symptomatic characters, treatments and prognoses.
RESULTS AND CONCLUSION: Totally 670 patients who underwent artificial hip replacement were selected including 16 patients with DVT, eleven patients with artificial femoral head replacement and five patients with unilateral total hip arthroplasty. The diagnoses included: 14 cases for femoral neck fracture, 1 case for avascular necrosis of femoral head, 1 case for hemophilia arthritis. The number of comorbidity was 1 to 4 in a patient, including hypertension, diabetes, rheumatoid arthritis, chronic renal failure and so on. All patients underwent standard mechanical and pharmacological thromboprophylaxis. Fourteen cases developed with swelling and pain in lower leg, and 2 cases developed with pulmonary embolism as the first symptom. Most patients recovered well. One patient of pulmonary embolism died of pulmonary infection which had no correlation with DVT, one patient of pulmonary embolism developed complication of cerebral bleeding after thrombolysis, which lead to persistent vegetative state. It is indicated that DVT morbidity can be reduced but can not eliminated by standard thromboprophylaxis. Hip fracture, long-lasting bed rest, aged, and co-existing medical diseases are the high-risk factors of DVT.