BMN Blog

JAN 18

When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored. 

 

Deep vein thrombosis (DVT) can develop after any major surgery and commonly occurs in the thigh or calf. People who have surgery on the lower extremities are especially at risk, which is why I incorporate this discussion with my patients. The American Academy of Orthopaedic Surgeons (www.AAOS.org) has developed patient education on the risks of DVT and provides a series of patient educational materials and videos.

 

Typical Warning Signs of Blood Clots

 

    • Pain in the calf and leg, unrelated to the incision
    • Tenderness or redness about or below the knee
    • Swelling of the thigh, calf, ankle or foot
    • Shortness of breath or chest pain

 

For my patients, immediately after joint replacements, to prevent DVT, I recommend the following:

 

  1. Mechanical compression devices such as calf or foot pumps
  2. Early ambulation to encourage working the lower extremity musculature
  3. Anticoagulant therapy

 

After hospital discharge, I recommend continuing daily anticoagulation therapy, and unless otherwise contraindicated, I incorporate a six-week course, at a minimum, using an enteric coated Aspirin 325mg/day. If a patient was already on anticoagulation therapy preoperatively, I typically restart their pre-op regimen after surgery.

 

Even with these preventive measures, a patient can still sometimes develop a DVT and pulmonary embolism. This is why it is important to rule out a DVT when a post-surgical patient presents with the blood clot warning symptoms.

 

It is so important to educate our patients to notify their healthcare professional to prevent a dangerous condition that can lead to possible death. Resource for sharing to patients can be found at www.orthoinfo.org.

 

 

Michael F. Blum, MD practices orthopaedic surgery with Southlake Orthopaedics Sports Medicine and Spine Center.

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