Certain kinds of patients have the highest risk of a DVT following joint replacement surgery.
A DVT is a deep vein thrombosis which could break off and travel to the lungs and be life threatening.
When it comes to knee replacement surgery, few patients just do not have a choice, and along with this extremely common procedure is the risk of DVT: deep vein thrombosis.
DVT has gotten a lot of attention lately within the context of extended air travel, but the king of DVT production is surgery, especially joint replacement.
A deep vein thrombosis is a blood clot. Part or all of it may break away and migrate into the lungs: a pulmonary embolus.
Tiny pulmonary emboli are not life-threatening, but massive or “saddle” pulmonary emboli can drop you in seconds — permanently.
This is why DVT prevention is critical.
Anyone can develop a pulmonary embolus if the perfect storm is in place, such as extended air travel while keeping the legs in the same cramped position; lack of hydration; being on birth control pills; excessive bed rest from a foot injury; and so many other circumstances.
Joint replacement patients are given DVT prevention treatment, namely blood thinners.
But certain joint replacement patients still have a relatively high risk of deep vein thrombosis.
A report in the Journal of Bone and Joint Surgery (2011) states that blood clot formation, including the pulmonary embolism, is a serious complication from knee replacement surgery.
The paper also says: “Prophylactic measures, such as the use of blood thinners around the time of surgery, are used to reduce the occurrence of clots, but their effectiveness in routine clinical practice following surgery is more uncertain.”
How the Study Was Done
- The study tracked over 37,000 knee replacement patients between 1997 and 2007.
- For 90 days after surgery is when pulmonary embolism risk is highest.
- There were 441 patients (1.2 percent) who had to be hospitalized for blood clots during this time window. The following risk factors were associated with clot formation:
– Over age 80
– History of previous clot
– History of cardiovascular disease
– Increased comorbidities (additional medical conditions like diabetes)
The study noted that knee replacement surgery is generally a safe procedure, but that people need to be very DVT-aware.
During the surgical consultation, patients should discuss blood clots and not leave the consultation without knowing precisely what the prevention measures will be.
Some surgeons will prescribe blood thinners for only the hospitalization duration.
“Despite the use of blood thinners, patients undergoing knee arthroplasty continue to remain susceptible to clot formation for several weeks following surgery,” says the paper.