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Abstract
Background and purpose Deep vein thrombosis is common after total joint replacement. It is frequently asymptomatic, and it is unclear whether this leads to longer-term problems such as post-thrombotic syndrome and leg ulceration. We investigated whether the postoperative prevalence of ulceration in patients who had undergone primary total hip replacement (THR) or total knee replacement (TKR) was higher than that found in a control group who had not undergone total joint replacement.
Methods The study group consisted of patients who had undergone THR or TKR at one orthopedic center 12–16 years previously without routine chemothromboprophylaxis, and who had not undergone revision surgery. The control group was recruited via primary care. All participants were recruited by post and asked to complete a questionnaire. Age- and sex-adjusted prevalence of self-reported leg ulceration was calculated, and logistic regression was used to determine whether there were any associations between THR or TKR and leg ulceration.
Results Completed questionnaires were received from 441 THR patients (54% response rate), 196 TKR patients (48%) and 967 control participants (36%). No statistically significant differences in age- and sex-adjusted prevalence of ulceration were found between the groups, for either lifetime prevalence or prevalence over the previous 15 years.
Interpretation Patients who undergo THR and TKR without chemothromboprophylaxis are unlikely to be at a higher risk of long-term venous ulceration than the normal population.
VW and AWB designed the study. VCG and VW gathered the data. AJS, VCG, and VW analyzed the data. VCG wrote the initial draft. All authors were involved in revising the manuscript.
This study was supported by a research grant from the North Bristol Trust Research and Innovation Small Grant Scheme. The current positions of Vikki Wylde, Alison Smith, and Ashley Blom are wholly or partly funded within a programme of independent research commissioned by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10070). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.
No competing interests declared.