use of plethysmography for deep venous thrombosis [DVT] detection in total hip replacement a different experience

The value of Plethysmography as a non-invasive technique to diagnose DVT compared to venography in joint replacement surgery was investigated. In the early post operative period most patients found plethysmography very painful to perform since the procedure involves hip and knee flexion up to 90 degree,s which is difficult in the early post operative days. Plethysmography is not suitable in early post-operative days in hip replacement surgery

Blood parameters as potential non invasive methods to diagnose deep venous thrombosis in T.H.R.

DVT is considered to be one of the major complications seen mainly after total joint replacement. The diagnosis of deep venous thrombosis [DVT] is carried out by clinical examination and objective investigations which confirm the clinical signs. Blood parameters as potential non-invasive methods are used to diagnose deep venous thrombosis in total hip replacement. The primary aim was to assess the accuracy of the blood tests, D-dimer, thrombin-antithrombin III complex and prothrombin fragments in diagnosing DVT in high risk patients using venography as a control. The second aim was to determine which of these blood markers is more accurate in diagnosing thrombosis. Blood samples were taken from 16 patients, 4 males and 12 females, aged from 55-86 years, all of them were admitted for hip replacement. In 5 out of 16 patients venography showed a positive DVT. Out of 16 patients only one had a clinically suspected DVT which was confirmed by venogram. The results showed significant differences for D-dimer when comparing pre-operative with post-operative levels in patients with proven DVT by venography. TAT results showed significant differences between pre-operative and post-operative results both in DVT positive and negative patients, and F 1 + 2 results were not significantly different between DVT positive and DVT negative patients. D-Dimer might be considered to be the most significant parameter among the three tests investigated which be might used as a screening test for DVT