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Risk of post-discharge venous thromboembolism in patients with rheumatoid arthritis undergoing knee or hip arthroplasty. Is prolonged thromboprophylaxis warranted or dangerous?
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Introduction |
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Venous thromboembolism (VTE)
that is, deep venous thrombosis
(DVT) and pulmonary embolism (PE)are common complications after major
hip or knee surgery. Without thromboprophylaxis, the incidence of DVT
in patients undergoing major orthopaedic surgery is more than 50%, and
fatal PE is reported to occur in 1-6% of these
patients.1 These data are based on investigations in which
predominantly osteoarthritis (OA) patients were studied. Only a few
(small) studies were performed in rheumatoid arthritis (RA) patients: Abernethy reports an incidence of DVT of more than 70% and overall incidence of PE of approximately 2% in RA patients who have undergone a knee arthroplasty,2 and Kelly reports, in his
review,3 an incidence of fatal PE of approximately 1% in
RA patients undergoing total hip replacement and not receiving
thromboprophylaxis (table 1). The risk of developing DVT seems to be
similar for RA patients undergoing total hip replacement and those
undergoing
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This article has been cited by other articles:
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NURMOHAMED, M T, DIJKMANS, B A C
(2001). Prevention of post-discharge venous thromboembolism in patients with rheumatoid arthritis undergoing knee or hip arthroplasty: a continuing matter of debate. Ann Rheum Dis
60: 905-907
[Full Text] -
van Heereveld, H A E M, Laan, R F J M, van den Hoogen, F H J, Malefijt, M C d. W., Novakova, I R O, van de Putte, L B A
(2001). Prevention of symptomatic thrombosis with short term (low molecular weight) heparin in patients with rheumatoid arthritis after hip or knee replacement. Ann Rheum Dis
60: 974-976
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