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DVT uncommon following elective hip arthroscopy
LYON, France — During a prospective study of 115 adult patients who underwent elective hip arthroscopy followed by bilateral duplex color sonography 2 weeks postoperatively, results showed five patients developed deep vein thrombosis.
“DVT [Deep vein thrombosis] following hip arthroscopy is not common. It is less than 5%. None of the clots were significant or proximal, and the signs and symptoms were obvious in the majority of these patients; therefore, we do not feel that routine screening or routine prophylaxis with anticoagulants is necessary,” Nicholas Mohtadi, MD, MSc, FRCSC, said in his presentation during the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Biennial Congress.
The distribution of sex was similar between the patients who developed DVT and those who did not. Patients in the DVT group had an older average age (43.8 years vs. 34.5 years) and a slightly lower BMI (23.5 vs. 24.8) compared with the non-DVT group. DVT patients also had more time in traction (38 minutes vs. 61 minutes). Forty percent of patients in the DVT group had a family history of the condition, compared with 11.8% of the non-DVT group.
Nicholas Mohtadi
There were no smokers in the DVT group vs. 13.6% in the non-DVT group. A higher percentage of patients in the DVT group were on hormone therapy compared with the non-DVT group. The researchers also found no significant association between the type of surgical procedure performed and the odds for DVT.
All patients with DVT came from one surgeon’s practice. One of the two surgeons participating in the study performed surgery with patients in the supine position, whereas the other surgeon performed surgery with patients in the lateral position, according to Mohtadi.
“They were comparable procedures, but the traction times were much less in those who had a DVT,” Mohtadi said.
The DVT group consisted of three women and two men between the ages of 27 years and 58 years. Two patients had a family history of DVT.
The patients’ DVT diagnosis was made within 3 weeks of surgery, and all patients were treated with aspirin, warfarin or newer anticoagulants. Of the five patients, four were symptomatic. All of the clots were in the peroneal vein or below it.
“This prospective series, which I believe is the first prospective study to look at DVT in this population, had found an incidence of 4.3%. There were no proximal DVTs that you would consider to be ‘sinister,’” Mohtadi said, noting that no pulmonary emboli were identified. – by Gina Brockenbrough, MA
Reference:
Mohtadi N, et al. Paper #111. Presented at: International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Biennial Congress; June 7-11, 2015; Lyon, France.
Disclosure: Mohtadi reports no relevant financial disclosures.