PREVENTION OF DEEP VENOUS THROMBOSIS IN POST-OPERATIVE ARTHROPLASTY PATIENTS WITHOUT USE OF ANTICOAGULANT THERAPY

Background: Deep vein thrombosis (DVT) is one of the most common complications of total hip (THA) and total knee arthroplasty (TKA), mostly due to immobilisation and to some extent due to pre-existing co-morbidities along with genetic predisposition. Though the reported incidence of DVT is very high in multiple studies, fatal thromboembolism is very rarely seen in clinical setup. Hence the issue of prophylaxis for DVT remains highly debated1. The incidence of DVT is largely based on various studies in European and American populations. Asian population is genetically and socially quite different from American and European populations, so the incidence of DVT can be quite different2. We conducted a retrospective study at our centre to determine incidence of DVT after THA and TKA in Indian patients. Methods: A retrospective study was conducted on in 45 patients and who underwent THA and TKA respectively, without any known risk factors for thromboembolic disease. No prophylaxis was given to the patients. The patients were monitored in the post op period for any signs and symptoms of DVT along with starting of adequate physiotherapy Results: DVT was found in one patient who had undergone THA, which was confirmed on colour Doppler ultrasonography of the affected limb. No case of DVT was detected in any patient who had undergone TKA. Conclusion: These results suggest that the incidence of DVT in patients is very low and is not comparable when adequate postoperative mobilisation and physiotherapy was done.We conclude that advising prophylactic anticoagulant therapy to these patients in the post op period could be successfully substituted by a simple and cost effective but adequate physiotherapy prevent DVT, in the process also bypassing the side effects of the anticoagulant therapy.