Abstract
Introduction. The aim of research was estimating risk factors for lower limbs DVT after hip and knee replacement. Material. We reviewed series of 80 patients (58 women and 22 men) who had performed 13 cemented THA, 38 uncemented THA, 19 TKA and 10 revisions after THA. Average patients age was 63 (range 45 to 82).
Methods. All patients were preoperatively taken precise history data and examined physically. We noticed their age and BMI. All patients were asked about past DVT, cardiovascular diseases and others, past operations, drug taking, condiments. We examined both lower limbs in suspicion of DVT. All patients were taken laboratory tests, D-dimers test, and two-dimensional and Doppler ultrasonography. During the operation we noticed its time, kind of anaesthesia, amount of blood and other transfusions, loss of blood, time of using the tourniquet (in TKA). After operation we noticed amount of blood and other transfusions, loss of blood, time of patients postoperative tilting to vertical position. All patients were precisely examined physically every day after joint replacement. They were taken laboratory tests in 1st, 4th, 7th and 14th day after operation. In 7th and 14th day we performed two-dimensional and Doppler ultrasonography. In all patients we used the same scheme of DVT prophylaxis. We administered Enoxaparine once a day subcutaneously (first dose 12 hours before operation). Prophylaxis lasted 6 weeks after joint replacement.
Results. Average DVT rate was 24,24%. We found the highest rate of DVT after replacement revisions (75%). The lowest rate was after uncemented THA (6,25%). There were no difference in DVT rate between women and men. We found significantly higher DVT rate in patient older than 60 yr. We found significantly higher DVT rate in patient with BMI over 30. We found significantly higher DVT rate in group of smokers. We found the operation was longer the DVT rate was higher. In case of delaying patients tilting to vertical position, DVT rate was higher. We did not find using tourniquet influence DVT rate.
Conclusions. The risk factors for DVT after hip and knee replacement are: age over 60 yr, BMI over 30, smoking, long lasting operation, delayed tilting to vertical position, accompanying cardiovascular diseases and past DVT.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
