Today's News

Friday, March 2, 2001

Risk of TED following THA can be reduced

The efficacy of early mobilization facilitated by epidural analgesia in the prevention of thromboembolism (TED) following total hip arthroplasty (THAs) was evaluated Thursday in a study in scientific paper 78. The researchers concluded that the risk of TED following THAs appeared to have been influenced by early mobilization with the advances of critical pathways and shortened hospital stay over the past decade. They say the data suggest that with prophylaxis, the risk of TED can be even further reduced.

Their study involved 273 consecutive patients without any significant comorbidity of TED who underwent unilateral THAs using standardized surgical techniques. All surgeries were done with the posterior approach under normotensive anesthesia. The mean age was 64 years.

Eighty-three percent of the patients received epidural analgesia for three days. No pharmacologic or mechanical prophylaxis for TED was used.

No fatal PE occurred. The incidence of DVT was 6.6 percent (doppler), and PE (V/Q scan) and clinical symptoms was 3.7 percent. There were 4.4 percent proximal and 2.2 percent distal clots. Two of 10 PEs were symptomatic. Forty-four percent of patients with positive V/Q also had positive doppler scan. No other patient has symptomatic TED in the 90-day clinical surveillance period.

The researchers are Christopher L. Forthman, MD, Boston, Mass.; Michael H. Huo, MD, Kansas City, Kan.; Clayton E. Turner, MD, Casper, Wy.; and Philip C. Noble, PhD; and Glenn C. Landon, MD, both of Houston, Texas.

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2001 Academy News March 2 Index C

Last modified 15/February/2001 by IS