Chapel Hill - Surgeons at the University of North Carolina at Chapel Hill have discovered they can almost always prevent life-threatening blood clots from forming during total hip replacement surgery.
They have their patients wear a sterile, inflatable sleeve over the leg as it's being operated on and for a few days afterwards. Inflating and deflating in waves, the sleeve stimulates blood flow inside leg veins comparable to the flow walking and other movements produce.
The procedure, which adds just a few minutes to preoperative preparations, avoids the need for blood-thinning drugs such as heparin and warfarin. Those drugs also prevent clot formation and have been widely used for many years, the surgeons say, but they significantly boost the risk of dangerous bleeding in the hip or elsewhere.
A report on the clinical study appears in the May issue of the Journal of Bone and Joint Surgery, an orthopaedic surgery journal. Authors are medical student Jennifer A. Hooker and Drs. Paul F. Lachiewicz and Scott S. Kelley, professor and associate professor of orthopaedic surgery, respectively, at the UNC-CH School of Medicine.
"Total hip replacement is very common now and is the most effective treatment for arthritis and other painful conditions of the hip in adults," Lachiewicz said. "Probably the most common early complication of the operation is developing blood clots in the legs, also called thrombophlebitis or thromboembolism."
Such clots can produce pain and swelling, he said, but the most serious complication results when they break off and flow to the lungs, causing pulmonary embolism and sometimes death. Blood-thinning drugs can cause excessive bleeding during and after the surgery and other serious complications.
"We came up with the idea that we might be able to avoid the drugs and
still prevent blood clots at the same time by using what we call intermittent
pneumatic compression and a
Contact: David Williamson
University of North Carolina at Chapel Hill