Recommended prophylaxes don't necessarily prevent deep vein thrombosis from developing in patients following hip or knee replacement, according to a report in the Journal of the American Medical Association.
About 1 in 100 patients who undergo total or partial knee arthroplasty and 1 in 200 patients who undergo total or partial hip arthroplasty will suffer DVT before hospital discharge, notes the study.
Those estimates might not reflect the true dangers of DVT, says John Heit, MD, a cardiologist at the Mayo Clinic in Rochester, Minn. "The period of risk extends beyond the duration of hospitalization, which these days, is really quite short, " he writes in an accompanying editorial.
So what steps can you take to protect joint replacement patients?
Last summer, the FDA approved a once-a-day anticoagulant pill intended for patients who undergo hip or knee replacement surgery.
Outpatient Surgery readers shared their ideas, which include assessing patients' risk factors and having patients wear compression stockings or sequential compression devices for any procedure lasting longer than 1 hour.
Monitor, detect and treat clots early, says Edward Mackay, MD, FACS, RVT, RPVI, a Florida-based vascular surgeon specializing in venous disorders and diseases. He advises you to act quickly if patients complain of pain, swelling, redness or inflammation of the legs, ankles or feet, or chest pain and shortness of breath.
Daniel Cook
