The incidence of symptomatic venous thromboembolic events in orthopaedic surgery when using routine thromboprophylaxis

Abstract

Few studies have shown the effect of thromboprophylactic regimen with low molecular weight heparin (LMWH) on the incidence of clinical venous thromboembolism (VTE) in common practice. The aim was to study the three-year incidence of clinically overt VTE events at a university based orthopaedic department with some 3300 operations performed and 15 000 patients treated annually. Since all Swedish citizens have an individual identification number it was possible tp follow up all patients operated during a 3 year period (2000-2002) for a period of four months. The incidence of VTE in the classical high-risk groups of hip fracture surgery, total hip arthroplasty (THA) and total knee arthroplasty (TKA) was low - about 0.6 %, while the Pulmonary embolism (PE) incidence in the hip fracture group was 0.27%, with two cases of fatal PE occurring 72 and 109 days after surgery. Patients with ankle fractures had more VTE. The majority of clinical VTE occurred after discharge from hospital. When using routine thrombopropylaxis with LMWH in orthopaedic surgery the rate of symptomatic VTE is low.