Mant Michael J, Eurich Dean T, Russell Donald B, Majumdar Sumit R
Department of Medicine, Division of Hematology and Oncology, University of Alberta, Edmonton, Canada.
Acta Orthop. 2008 Dec;79(6):794-9. doi: 10.1080/17453670810016876.
Deep vein thrombosis (DVT), usually asymptomatic, is common after total hip arthroplasty (THA). Post-thrombotic syndrome (PTS) is a potential late complication of DVT, but there is limited data on its occurrence.
This was a prospective cohort study of subjects at one hospital who had participated in a trial of thromboprophylaxis for THA and who had postoperative venography. Data were collected at baseline and 2-4 years later to ascertain symptoms of PTS using a modification of a validated scoring system. Outcomes were collected without knowledge of baseline characteristics or venogram results. Potential predictors of PTS were explored using exact logistic regression analyses.
The cohort (n=188) had a mean age of 63 years, 51% were male, 35% had a BMI of>30, and 4% had a prior history of DVT. 25 patients (13%) had DVTs on venography. 12 patients (6%, 95% CI: 3-11) subsequently developed symptoms consistent with PTS, 7 with bilateral symptoms. Most affected limbs (15 of 19) had no postoperative DVT. No statistically significant predictors of PTS were found.
Symptoms of PTS are infrequent after THA in patients who receive some form of thromboprophylaxis. Our findings, which are consistent with the existing literature, suggest that there is a potential benefit to giving thromboprophylaxis for reduction of symptomatic PTS.
深静脉血栓形成(DVT)通常无症状,在全髋关节置换术(THA)后很常见。血栓形成后综合征(PTS)是DVT的一种潜在晚期并发症,但关于其发生率的数据有限。
这是一项对一家医院中参与THA血栓预防试验且术后接受静脉造影的受试者进行的前瞻性队列研究。在基线时和2至4年后收集数据,使用经过验证的评分系统的改良版来确定PTS的症状。在不知道基线特征或静脉造影结果的情况下收集结局数据。使用精确逻辑回归分析探索PTS的潜在预测因素。
该队列(n = 188)的平均年龄为63岁,51%为男性,35%的体重指数(BMI)>30,4%有DVT既往史。25例患者(13%)静脉造影显示有DVT。12例患者(6%,95%置信区间:3 - 11)随后出现与PTS相符的症状,7例有双侧症状。大多数受累肢体(19例中的15例)术后无DVT。未发现PTS的统计学显著预测因素。
在接受某种形式血栓预防的THA患者中,PTS症状并不常见。我们的研究结果与现有文献一致,表明进行血栓预防对于减少有症状的PTS可能有益。