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Serious Symptomatic Thromboembolic Events in 500 Consecutive Total Hip Arthroplasty Patients: A Prospective Observational Cohort Study

Camilla Ryge, Michael R Lassen, Stig Sonne-Holm, and Soeren Solgaard

Objectives:To describe the rate and time of onset of serious symptomatic thromboembolic complications within the first 90 postoperative days in an unselected population of total hip arthroplasty (THA) patients.Patients/Methods: 500 consecutive elective THA patients recruited from January 2004 until May 2005. Patients were interviewed before surgery, on the fifth postoperative day, and 90 days postoperatively. A total of 498 patients had 90 days of follow-up. Results: 24 patients (4.8% [95% confidence interval 2.93–6.70]) experienced at least one serious symptomatic thromboembolic complication during the first 90 postoperative days. Two patients (0.4%) died. Five patients (1.0%) suffered a pulmonary embolism, one (0.2%) had a myocardial infarction, 10 (2.0%) developed deep venous thrombosis, two (0.4%) experienced retinal vein occlusion, and four (0.8%) had transitory cerebral ischemia. Overall, 62% of these patients experienced their event after the fifth postoperative day. Patients operated on because of idiopathic osteoarthritis had a significantly lower risk of developing thromboembolic complications than patients undergoing revision THA or primary THA because of secondary osteoarthritis. Use of cement, in association with older age (>70 years), was found to double the risk of thromboembolic complications in the first 90 postoperative days.Conclusion: This study shows that symptomatic venous and arterial thromboembolic complications continue to be a major contributor to postoperative morbidity and mortality after elective THA, despite the use of rigorous early mobilization and optimized short-term thromboprophylaxis regimens during hospital stay. Adv Orthop 2009;1(3):98–106.

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