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Hip Replacement Guidelines Issued For Avoiding Blood Clots

New hip replacement recommendations from the American Academy of Orthopaedic Surgeons (AAOS) Board of Directors offer guidelines for how doctors can prevent blood clots in patients after they undergo the procedure.

 

After surgery, patients should be encouraged to get up and walk as soon as possible. Postoperative screenings for thromboembolic disease duplex ultrasonography (an ultrasound test of blood movement) were not found to reduce the risks of blood clots known as DVT (deep vein thrombosis) or PE (pulmonary embolism). Patients should also receive anticoagulant therapy and mechanical compression devices, which should be tailored to the individual patient.

The academy's recommendations before hip replacement surgery include patients discussing a history of prior blood clots with physicians, and a timeline for stopping any medications, such as antiplatelet medications or aspirin, which can lead to blood loss. Opting for regional anesthesia during surgery also limits blood loss.

Deep vein thrombosis (DVT), or a blood clot in the leg, occurs in about 37 percent of patients who have undergone hip or knee replacements. In some cases, the blood clot can travel through the veins to the lungs and become pulmonary embolism (PE). Neither necessarily causes symptoms, but DVT can cause leg pain and lead to hospitalization, and PE symptoms include shortness of breath, light-headedness or chest pain. In some cases PE can be fatal.

"After looking at all available scientific research evidence, in a rigorous fashion to minimize bias, we made recommendations that can help guide practitioners in the safest and most effective ways to prevent this potentially serious complication," Dr. Joshua Jacobs. the academy second vice president and orthopaedic surgeon at Rush University Medical Center in Chicago, told ScienceDaily.

Full guidelines are available from AAOS.

 
 
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The Operating Theatre Journal, OTJ, is published monthly and distributed to every hospital operating theatre department in the UK. The distribution includes both the National Health Service and the Private Sector.

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