Detection of Asymptomatic Venous Thrombosis following Hip Replacement Surgery: Retrospective evaluation of routine screening by duplex ultrasonography based on 286 cases

This study evaluates a pragmatic approach using duplex ultrasonography (US) for detecting venous thromhosis (VT) after total hip arthroplasty (THA).

Venous B-mode and colour duplex US examination of both legs including a systematic evaluation of calf veins was performed twice during hospitalisation in 286 consecutive patients. VT was diagnosed in 31 patients (12%). Thrombosis was asymptomatic in 28 patients (90%), and was bilateral or concerned the non-operated leg in 6 patients (19,4%). No clinical pulmonary embolism occurred during hospitalisation. Prior phlebitis and age over 70 were identified as statistically significant risk-factors (p<0,02 and p<0.04 respectively). All patients were seen at three months. Four patients (1.6%) developed VT between hospital discharge and the 3-month follow-up visit.

Venous US performed twice after THA detected VT in 31 patients, 90% of these were asymptomatic. This approach might explain the absence of pulmonary embolism (PE) in our series, and support a systematic evaluation of the vein of the lower limb with ultrasonography after THA.