A Practical Screener for Deep Vein Thrombosis after Total Hip Replacement

Abstract

A new non-invasive screener for the detection of proximal deep vein thrombosis was evaluated in two consecutive series of patients undergoing primary total hip replacement. The system, which utilises computerised strain gauge venous occlusion plethysmography, was simple to use and allowed serial screening of large numbers of patients without complication. Comparison with venography in 112 patients gave a specificity of 96% (106/110) and a sensitivity of 100% (2/2) for clinically important proximal DVT. Based on this study, a larger management study was performed. After total hip replacement, 516 patients were serially screened and all were followed to at least four months (mean 7.6 months) from surgery. Venography was only requested after a positive screening test. The screener correctly identified proximal and major calf thrombi in this group allowing early treatment. There were no fatal pulmonary emboli. This initial assessment suggests that computerised strain gauge plethysmography may be useful in identifying those patients with silent venous thrombosis after total replacement.