Tone Shine, Naito Yohei, Wakabayashi Hiroki, Sudo Akihiro, Hasegawa Masahiro
Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, Tsu, Japan.
Yonaha Okanoue Hospital, Kuwana, Japan.
Eur J Orthop Surg Traumatol. 2025 Apr 25;35(1):167. doi: 10.1007/s00590-025-04291-8.
This study aimed to evaluate the necessity of anticoagulant therapy with an Xa inhibitor for asymptomatic acute distal lower-limb deep vein thrombosis (DVT) detected on ultrasonography after total hip arthroplasty (THA).
After exclusions, patients who underwent primary cementless THA were divided into treatment and no-treatment groups based on whether they received anticoagulant therapy with an Xa inhibitor for asymptomatic acute distal lower-limb DVT. Residual distal lower-limb DVT at 3 months, incidence of proximal DVT, and symptomatic venous thromboembolism (VTE) after THA were compared between the groups.
A total of 574 patients met the inclusion criteria (treatment group, n = 287; no-treatment group, n = 287). Residual distal lower-limb DVT at 3 months was detected in 3 patients (1.0%) in the treatment group and in 10 patients (3.5%) in the no-treatment group. No symptomatic VTE was observed in either group. No significant difference was observed between the two groups, although the no-treatment group tended to have a higher residual rate of acute distal lower-limb DVT.
The necessity of anticoagulant therapy for asymptomatic acute distal lower-limb DVT was not confirmed.
本研究旨在评估全髋关节置换术(THA)后超声检查发现的无症状急性下肢远端深静脉血栓形成(DVT)患者使用Xa因子抑制剂进行抗凝治疗的必要性。
排除相关病例后,接受初次非骨水泥型THA的患者根据是否接受Xa因子抑制剂抗凝治疗以治疗无症状急性下肢远端DVT分为治疗组和非治疗组。比较两组患者术后3个月下肢远端残余DVT、近端DVT发生率及有症状静脉血栓栓塞症(VTE)的情况。
共有574例患者符合纳入标准(治疗组,n = 287;非治疗组,n = 287)。治疗组3例患者(1.0%)在术后3个月发现下肢远端残余DVT,非治疗组有10例患者(3.5%)出现。两组均未观察到有症状的VTE。两组之间未观察到显著差异,尽管非治疗组急性下肢远端DVT的残余率有升高趋势。
未证实无症状急性下肢远端DVT进行抗凝治疗的必要性。