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Orthopedics. 1994 Jul;17 Suppl:14-7.

Secondary prevention of venous thromboembolism in joint replacement using duplex ultrasonography.

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Division of Orthopedic Surgery, Scripps Clinic and Research Foundation, LaJolla, Calif.


Prophylaxis of venous thromboembolism can be categorized as primary prevention and secondary prevention. Primary prevention is the deterrence of a disease process before it begins. Secondary prevention is the detection and treatment of an asymptomatic disease process before it becomes symptomatic. This discussion deals with duplex ultrasonography as a method of secondary prevention of venous thromboembolism after total joint replacement. Routine screening by venography and by duplex ultrasonography has been advocated by several authors in cases of total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, compared with venography, duplex ultrasonography has the advantages of being portable, painless, noninvasive, without side effects, less expensive and, depending on the institution, reliable as a screening and surveillance tool for managing deep vein thrombosis (DVT). Part one of a three-part study was designed to substantiate reliability of duplex ultrasonography in detecting DVT after total joint replacement in the lower extremity at our institution (Scripps Clinic and Research Foundation in La Jolla, Calif). Parts two and three were designed to evaluate the utility of duplex ultrasonography for routine screening and surveillance of DVT after THA and TKA.

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