Ileus following total hip or knee arthroplasty is associated with increased risk of deep venous thrombosis and pulmonary embolism

Ileus, failure of forward movement of bowel, complicates up to 4.0% of total hip and total knee arthroplasty (THA and TKA).Venous thromboembolic disease (VTD), deep venous thrombosis (DVT), and pulmonary embolus (PE), are a cause of morbidity and mortality following THA and TKA. We examined the relationship between ileus and VTD. We reviewed the clinical course of 3364 consecutive THA, TKA, revision THA, revision TKA, radical debridement for infection, and reimplantation in 2949 patients performed at one institution over a two-year period. VTD prophylaxis consisted of aspirin and intermittent plantar pulse boots for all patients except those at high risk that received parenteral chemical prophylaxis and boots. Symptomatic DVT was diagnosed by duplex sonography. Patients did not undergo surveillance. VQ scan or spiral CT confirmed symptomatic PE. Odds ratios were calculated by Fisher’s exact test.