TUESDAY, Jan. 17 (HealthDay News) -- One of every 100 people
undergoing knee replacement surgery and 1 of 200 people having hip
replacement surgery will develop a blood clot before they leave the
hospital, even if they take steps to prevent the development of
these blood clots, a new evidence review suggests.
A deep venous thrombosis (DVT) or blood clot can form deep
within the veins, usually in the leg. The real risk occurs if these
blood clots dislodge, travel through your bloodstream, and block
blood flow in your lungs, which is called pulmonary embolism.
The new study, published in the Jan. 18
Journal of the American Medical Association, seeks to provide a reliable benchmark of this risk, but many experts in the field worry that the actual risk of blood clots after joint replacement is really much higher than this study suggests.
Researchers led by Jean-Marie Januel, of the Lausanne University
Hospital, in Switzerland, analyzed 47 studies comprising nearly
45,000 joint replacement cases. All patients received preventive
measures to lower their risk of developing a blood clot. Despite
this treatment, one in every 100 patients undergoing knee
replacement and 1 in every 200 patients undergoing hip replacement
developed a blood clot before hospital discharge. Prevention
typically involves getting patients moving soon after surgery,
providing compression stockings or boots and administering some
type of medication that prevents clots from forming.
Dr. John Heit, a cardiologist at the Mayo Clinic in Rochester,
Minn., wrote an editorial accompanying the new report.
"The authors are trying to estimate the magnitude of the problem among patients who receive the most effective prophylaxis available today," Heit said. But the risk is actually much higher than the study suggests, he said. "One has to understand the period of risk extends beyond the duration of hospitalization, which these days, is really quite short."
He added, "Orthopedic surgeons are very aware of this problem
and do an excellent job in choosing patients that are most likely
to benefit from surgery, and they are very religious in terms of
providing some form of prophylaxis after surgery."
Dr. Joel Buchalter, an orthopedic surgeon at Somers Orthopaedic
Surgery and Sports Medicine Group in Carmel, N.Y., agreed. He said
that the risk of blood clots after joint replacement surgery may be
even higher. The new study looked only at patients who developed
blood clots in the hospital, but these blood clots can develop
weeks after the surgery, he said.
Signs of a blood clot may include swelling, tenderness and pain
when flexing the ankle, Buchalter said. "If a person has any of
these symptoms, an ultrasound exam can rule a blood clot in or out,
but many times blood clots have no symptoms. Some people have a
great-looking leg and have a blood clot and don't even know it," he
Dr. Mathias Bostrom, an orthopedic surgeon at the Hospital for
Special Surgery in New York City, said that the risk for blood
clots after a joint replacement is real. "The new study once again
reinforces that even in 2012, the risk of blood clots after total
knee or hip replacement surgery is significant," Bostrom said.
There are many new drugs available today to help lower risk for
blood clots after surgery, but these do have risks of their own, he
Learn more about
deep vein thrombosis at the American Academy of
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