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COMPLICATIONS OF ORTHOPAEDIC SURGERY

Willis AA, Warren RF, Craig EV et al.
J Shoulder Elbow Surg 2009;18:100–6.

In this prospective study, the authors showed that the rate of venous thromboembolism is not negligible after reconstructive shoulder arthroplasty, highlighting the need for better individual patient risk stratification.

This single-center, clinical study was performed to assess the prevalence of deep venous thrombosis (DVT) after prosthetic shoulder replacement surgery. The authors prospectively enrolled 44 male and 56 female patients (mean age 67 years, range 17–88 years) undergoing 100 consecutive shoulder arthroplasty procedures (total shoulder replacement in 73 and hemiarthroplasty in 27), and followed them for 12 weeks. Risk factors for venous thromboembolism (VTE) were assessed preoperatively and postoperatively. Four-limb surveillance color flow Doppler ultrasound was performed 2 days (n=100) and 12 weeks (n=50 randomly selected) after surgery. During the follow-up period, all patients were at least contacted by telephone. The presence and location of DVT was recorded. Postoperative symptomatic or fatal pulmonary embolism (PE) was also recorded. Before surgery, no DVT prophylaxis – such as elastic stockings, pneumatic compression devices, or heparin – was used. Following surgery, pneumatic compression foot pumps and early ambulation was started in all patients; 25 also received aspirin 325 mg twice daily.

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