Venous thromboembolic disease after hybrid hip arthroplasty with negative duplex screening

Postoperative duplex ultrasonography screening after total hip arthroplasty has been shown to identify patients who may require treatment or additiona l monitoring for venous thromboembolic disease. The potential for manifesta tion of venous thromboembolic disease subsequent to screening remains a con cern. The objective of this study was to determine the prevalence of sympto matic venous thromboembolic disease after total hip arthroplasty and after inhospital prophylaxis, inhospital screening with negative results for prox imal deep venous thrombosis, and no posthospitalization venous thromboembol ic disease prophlaxis. One hundred fifty patients undergoing primary hybrid total hip arthroplasty and using pneumatic compression stockings and aspir in as prophylaxis against venous thromboembolic disease were screened for d eep venous thrombosis with duplex ultrasonography on the fourth day after s urgery. Duplex ultrasonography screening revealed 17 (11.3%) patients with asymptomatic proximal deep venous thrombosis. In response to duplex ultraso nography screening, these patients with proximal deep venous thrombosis rec eived therapeutic anticoagulation, Of 133 patients with a duplex screen wit h negative results for proximal deep venous thrombosis, 131 (98.5%) continu ed to have no symptoms of venous thromboembolic disease and two (1.5%) bega n to hare symptoms for venous thromboembolic disease (one with proximal dee p venous thrombosis, one with nonfatal pulmonary embolism) during IZ months of clinical followup after total hip arthroplasty. The overall prevalence of venous thromboembolic disease requiring anticoagulation was 19 of 150 (1 2.6%) patients, The remaining 131 (87.4%) were not exposed to the risks of postoperative anticoagulation and did not have subsequent symptomatic venou s thromboembolic disease.