Aali Rezaie Arash, Azboy Ibrahim, Parvizi Javad
The Rothman Institute, Thomas Jefferson University, 125 S 9th St. Ste 1000, Philadelphia, PA, USA.
İstanbul Medipol University, Department of Orthopaedic and Traumatology, Koşuyolu Medipol Hospital, İstanbul, Turkey.
J Hip Preserv Surg. 2018 Oct 1;5(3):181-189. doi: 10.1093/jhps/hny016. eCollection 2018 Aug.
Venous thromboembolism (VTE) is a serious complication after major orthopedic procedures. The best options for prevention of the VTE are still debated. The most popular evidence-based guidelines for prevention and treatment of VTE in orthopedic surgery addressed the total hip or knee arthroplasty and hip fractures as the major orthopedic surgeries. Majority of studies have evaluated the different modalities of the VTE prophylaxis in patients undergiong hip or knee arthroplasty. Hip preservation surgeries (HPS) including mini-open femoroacetabular osteoplasty, surgical dislocation of the hip, arthroscopic procedures, and periacetabular osteotomy (PAO) are gained popularity in recent two decades. The majority of these patients are young, healthy and active and may not be considered at high risk for VTE. The frequency of VTE in patients undergoing PAO seems to be low between 0 and 5%. There is a paucity of data regarding rates of VTE in young healthy patients undergoing HPS as well as the optimal prevention methods for VTE. Hence current VTE prevention guidelines do not cover HPS adequately. We aimed to review the available literature regarding VTE events and VTE prophylaxis options after HPS. We discussed the available and potential options for prophylaxis of VTE events in these procedures along with our experience in a large cohort of hip preservation surgery.
静脉血栓栓塞症(VTE)是大型骨科手术后的一种严重并发症。预防VTE的最佳选择仍存在争议。骨科手术中预防和治疗VTE最流行的循证指南将全髋关节或膝关节置换术以及髋部骨折视为主要骨科手术。大多数研究评估了接受髋关节或膝关节置换术患者的不同VTE预防方式。近二十年来,包括微创股骨髋臼截骨术、髋关节手术脱位、关节镜手术和髋臼周围截骨术(PAO)在内的保髋手术(HPS)越来越受欢迎。这些患者大多数年轻、健康且活跃,可能不被视为VTE的高危人群。接受PAO手术的患者中VTE的发生率似乎较低,在0%至5%之间。关于接受HPS的年轻健康患者的VTE发生率以及VTE的最佳预防方法的数据很少。因此,当前的VTE预防指南没有充分涵盖HPS。我们旨在回顾关于HPS后VTE事件和VTE预防选择的现有文献。我们讨论了这些手术中预防VTE事件的现有和潜在选择,以及我们在一大群保髋手术中的经验。