FACTOR-V-LEIDEN AND THE RISK OF PROXIMAL VENOUS THROMBOSIS AFTER TOTAL HIP-ARTHROPLASTY

Deep vein thrombosis (DVT) remains a major cause of morbidity in patie nts undergoing total hip arthroplasty (THA). Despite postoperative DVT prophylaxis, 20-50% of THA patients still develop DVT. Currently, the re is no accurate way of predicting which patients will develop DVT de spite standard prophylaxis. The presence of factor V Leiden is the mos t common cause of inherited DVT risk. It has been postulated that pati ents who have factor V Leiden and are subjected to thrombogenic stress ors such as THA would have an increased risk of thrombosis. The factor V Leiden genotype of 36 patients who developed proximal DVT after sur gery and 45 control patients who had THA but did not develop DVT was d etermined. All patients had had prophylaxis against thrombosis using i ntermittent pneumatic compression alone or in combination with warfari n or aspirin. Surveillance for proximal DVT was performed on all patie nts prior to discharge by duplex ultrasound. The 2 groups were similar in age, sex, and type of operation. Three of 36 study patients who ha d developed DVT (8%) and 2 of 45 control patients who had not develope d DVT (4%) were heterozygotes for factor V Leiden; these prevalences w ere not statistically different. Heterozygosity for factor V Leiden is not associated with DVT prophylaxis failure in patients undergoing TH A.