Has the incidence of deep vein thrombosis in patients undergoing total hip/knee arthroplasty changed over time? A systematic review of randomized controlled trials.

Abstract:

BACKGROUND:There is a perception in the orthopaedic and thromboembolism community that the incidence of deep vein thrombosis (DVT) has decreased in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). OBJECTIVES:To assess the incidence of DVT with warfarin thromboprophylaxis over time in patients undergoing elective TKA or THA. METHODS:The MEDLINE, EMBASE, and Cochrane Library databases were searched to October 2006, supplemented by a manual search of reference lists. Two reviewers independently extracted data on study characteristics, quality and the frequency of total, symptomatic and proximal DVT. RESULTS:Fourteen studies (4,423 patients) were included. Total and proximal DVT after TKA declined over time (r=-0.75, p=0.031; r=-0.86, p=0.007 respectively). Total and proximal DVT after THA did not change. The risk of developing DVT after TKA was significantly higher than after THA (OR 1.85, 95% CI 1.6-2.14; p<0.0001). The risk of developing symptomatic DVT after THA was significantly higher than after TKA (OR 2.18, 95% CI 1.11-4.27; p=0.012). CONCLUSIONS:The incidence of DVT in patients undergoing elective TKA appears to have declined in patients receiving warfarin thromboprophylaxis.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Xing KH,Morrison G,Lim W,Douketis J,Odueyungbo A,Crowther M

doi

10.1016/j.thromres.2008.05.005

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

24-34

issue

1

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(08)00168-0

journal_volume

123

pub_type

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