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Relationship Between Deep Vein Thrombosis and Pulmonary Embolism Following THA and TKA.
MedLine Citation:
PMID:  22385601     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) are at risk for venous thromboembolisms, including deep vein thrombosis and pulmonary embolism. Most deep vein thromboses are asymptomatic, but they can lead to long-term morbidity to the same extent as symptomatic events. The risk of complications of venous thromboembolisms depends on the location of thrombi; potential long-term complications include recurrent venous thromboembolism, postthrombotic syndrome, and chronic thromboembolic pulmonary hypertension. Risk of recurrence persists for several years after the initial event. Approximately 20% of recurrent events are pulmonary embolisms, and approximately half of those are fatal. The causal relationship between deep vein thrombosis and pulmonary embolism remains controversial. Some consider them distinct clinical entities, while others have found asymptomatic distal deep vein thrombosis to be associated with elevated risk of developing pulmonary embolism. Unique coagulation factors may be associated with orthopedic surgery patients that differentiate them from patients undergoing other types of surgery. Symptomatic and asymptomatic deep vein thrombosis can lead to the development of recurrent venous thromboembolism, pulmonary embolism, postthrombotic syndrome, and chronic thromboembolic pulmonary hypertension, all of which are associated with reduced quality of life and increased health care expenditures. Thromboprophylaxis is therefore important in patients undergoing THA or TKA. However, traditional anticoagulants are not ideal, particularly for long-term use. Orthopedic surgeons should be aware of the causes and potential sequelae of venous thromboembolism and of the new thromboprophylactic agents that can help prevent it.
Authors:
Jose Bosque; Sheldon I Coleman; Paul Di Cesare
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  35     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  228-33     Citation Subset:  IM    
Copyright Information:
Copyright 2012, SLACK Incorporated.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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