• Faik Altintaş, Hakan Gürbüz, Bülent Erdemli, Bülent Atilla, Recep Gür Ustaoğlu, Uğur Oziç, Oner Savk, Hüseyin Bayram, Recep Memik, Işik Akgün, Abdullah Göğüş, Fatih Pestilci, Adnan Konal, Mahmut Argün, Irfan Oztürk, Nevzat Dabak, Omer Faruk Bilgen, Erhan Serin, Cetin Onder, Aykin Simşek, Remzi Tözün, and Hakan Kinik.
• Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Yeditepe University, Istanbul, Turkey. faltintas@yeditepe.edu.tr
• Acta Orthop Traumato. 2008 Nov 1; 42 (5): 322-7.

ObjectivesWe investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS).MethodsAn open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients.ResultsRisk factors for VTE were seen in 73.2% of the patients, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively.ConclusionEffective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.

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