Department of Orthopaedic Surgery, William Beaumont Hospital, 30575 Woodward Avenue, Royal Oak, MI 48073, USA.
J Bone Joint Surg Am. 2011 May;93 Suppl 2:62-5. doi: 10.2106/JBJS.J.01769.
Venous thromboembolism, a known complication of orthopaedic procedures, is thought to be more prevalent following hip surgery. Venous thromboembolism risk assessment and appropriate prophylaxis according to the American College of Chest Physicians guidelines has become the standard of care. However, it is accepted that venous thromboembolism prophylaxis is associated with potential adverse sequelae including hematoma, wound drainage, and infection. Little is known regarding the incidence of venous thromboembolism following periacetabular osteotomy and the necessity for and method of routine prophylaxis.
A total of 1067 periacetabular osteotomies performed at six North American centers utilizing different methods of prophylaxis against venous thromboembolism were analyzed for type of prophylaxis and incidence of clinically symptomatic venous thromboembolism.
There were four cases of pulmonary embolus and seven cases of deep vein thrombosis. There were no reported deaths. The crude incidence of clinically symptomatic venous thromboembolism was 9.4 per 1000 procedures.
The risk from chemoprophylaxis and the development of hematoma may be greater than the risk of clinically important venous thromboembolism in patients undergoing periacetabular osteotomy.
静脉血栓栓塞症是骨科手术的已知并发症，人们认为其在髋关节手术后更为常见。根据美国胸科医师学会指南进行静脉血栓栓塞风险评估和适当的预防措施已成为常规护理标准。然而，人们公认静脉血栓栓塞预防措施与潜在的不良后果有关，包括血肿、伤口引流和感染。对于髋臼周围截骨术后静脉血栓栓塞的发生率以及常规预防的必要性和方法知之甚少。
对北美六个中心进行的 1067 例髋臼周围截骨术进行了分析，这些中心采用了不同的预防静脉血栓栓塞的方法，分析了预防的类型和临床症状性静脉血栓栓塞的发生率。
有 4 例肺栓塞和 7 例深静脉血栓形成。没有报告死亡病例。临床症状性静脉血栓栓塞的粗发生率为每 1000 例手术 9.4 例。
对于接受髋臼周围截骨术的患者，化学预防和血肿形成的风险可能大于临床重要静脉血栓栓塞的风险。
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