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Significantly lower incidence of VTE found with periacetabular osteotomy
Patients who underwent surgery for hip fracture experienced a significantly higher incidence of VTE.
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Patients who underwent periacetabular osteotomy had a significantly lower incidence of venous thromboembolism compared with patients who underwent surgery for hip fractures, total hip arthroplasty and revision total hip arthroplasty, according to study results.
“This study shows precise information for [venous thromboembolism] VTE in patients undergoing hip surgeries treated by almost the same protocol at a single hospital,” Yasuhiro Yamanaka, MD, of Sapporo City General Hospital, told Orthopedics Today. “The results of this data indicate that the incidence of VTE after periacetabular osteotomy is significantly lower than surgery for hip fracture and relatively lower than [total hip arthroplasty] THA and revision THA.”
Incidence of VTE
Yamanaka and his colleagues retrospectively studied 820 hip surgeries performed at the Asahikawa Medical University between 2006 and 2012, including 420 primary THAs, 91 revised THAs, 144 periacetabular osteotomies and 165 hip fractures. Researchers used Multidetector CT and ultrasound to detected VTE.
Results showed an overall incidence of VTE of 12.2%, with a significantly higher incidence of VTE found in hip fracture surgeries (18.1%) compared with periacetabular osteotomies (2.1%). Researchers also found a higher incidence of VTE following THA (13.1%) and revision THA (13.2%). Patients had an incidence of pulmonary embolism of 1.5%, with patients who underwent periacetabular osteotomies having no incidence of pulmonary embolism compared with patients who underwent THA (1.2%), revision THA (1.1%) and hip fracture surgery (4.2%).
Although the use of chemoprophylaxis therapy proved to be relatively effective in hip fracture surgeries, researchers found anemia, hepatic dysfunction and an increase of infection rate in patients after chemoprophylaxis therapy.
Significant differences
Between patients with or without a thrombotic event, researchers noted no significant differences with respect to prosthesis or diagnosis after THA, operative procedure and diagnosis after revision THA and operative procedure after periacetabular osteotomy and hip fracture surgery. Although results showed no significant difference in incidence rate of VTE with respect to gender, intraoperative blood loss and operating time, there was a significant difference in age. In addition, a high incidence of VTE also may be affected by vessel damage by trauma, preoperative waiting time and bed rest.
“This data shows that the incidence of VTE after hip surgery is higher than expected and prophylaxis therapy was effective,” Yamanaka said.
He added that the higher incidence of VTE found after hip fracture surgery should be noted for future surgeries and that the potential patient-related risk factors for VTE need to be investigated in future research since these were not examined in this current study. – by Casey Tingle
- Reference:
- Yamanaka Y, et al. Open Orthop J. 2016;doi:10.2174/1874325001610010252.
- For more information:
- Yasuhiro Yamanaka, MD, can be reached at Sapporo City General Hospital 1-1 North-11 West-13, Chuou-ku, Sapporo, Japan 060-8604; email: yyamanak@asahikawa-med.ac.jp.
Disclosure: Yamanaka reports no relevant financial disclosures.