[Incidence and distribution of venous thrombosis of the lower limbs diagnosed by duplex ultrasonography after total hip or total knee arthroplasty, and hip fracture surgery. Results from 5981 exams and 2123 cases of venous thrombosis over 10 years]

Abstract

Aim: To determine the incidence and distribution of lower limb venous thrombosis diagnosed by duplex ultrasonography, including calf exploration, after total hip or knee replacement or hip fracture, and to compare them with the venographic results reported by recent randomized control trials testing new antithrombotic drugs.

Patients and methods: From January 2001 to December 2009, 30,510 standardized report forms incremented a database from which files corresponding to major orthopaedic surgery were selected: 1652 after total hip replacement (THR), 1440 after total knee replacement (TKR) and 2889 after hip fracture (HF). Base-line characteristics, incidence and anatomic distribution of venous thrombosis were analysed in the three populations.

Results: Systematic screening was applied for 95.1% of the exams (n=5689). Incidence of total and proximal venous thrombosis was, respectively, 27.8% (n=460) and 2.8% (n=46) for THR, 32.5% (n=939) and 4.4% (n=126) for HF, and 50.3% (n=724) and 3.8% (n=55) for TKR. Venous thrombosis was distal in 89.3% (n=1896). More than half (n=1014) of distal venous thromboses were strictly muscular soleal locations. Ilio-caval thrombosis incidence was 0.18% (n=11), and superficial venous thrombosis incidence was 1.5% (n=89).

Conclusion: This study shows that incidence and distribution of venous thromboses diagnosed with a complete and standardized duplex ultrasonographic screening are very close to the rates published with venographic screening in recent trials.