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Scientific Articles   |    
Incidence of Deep Vein Thrombosis and Pulmonary Embolus Following Periacetabular Osteotomy
Ira Zaltz, MD1; Paul Beaulé, MD2; John Clohisy, MD3; Perry Schoenecker, MD4; Daniel Sucato, MD5; David Podeszwa, MD6; Rafael Sierra, MD7; Robert Trousdale, MD7; Young-Jo Kim, MD, PhD8; Michael B. Millis, MD8
1 Department of Orthopaedic Surgery, William Beaumont Hospital, 30575 Woodward Avenue, Royal Oak, MI 48073. E-mail address: zaltzira@gmail.com
2 Division of Orthopaedic Surgery, Ottawa Hospital – General Campus, Critical Care Wing, Room W1646, Box 502, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
3 Washington University Orthopedics, 660 South Euclid Avenue, Campus Box 8233, Suite 11300 West Pavilion, St. Louis, MO 63110
4 Shriner's Hospital for Children, 2001 South Lindbergh Boulevard, St. Louis, MO 63131
5 Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219
6 Department of Orthopaedic Surgery, Children's Medical Center, 1935 Medical District Drive, E2300, Dallas, TX 75235
7 Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 First Street S.W., Gonda 14, Rochester, MN 55905
8 Department of Orthopaedic Surgery, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits of less than $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Medtronic).

Investigation performed at the William Beaumont Hospital, Royal Oak, Michigan; University of Ottawa, Ottawa, Ontario, Canada; Washington University School of Medicine, St. Louis, Missouri; Texas Scottish Rite Hospital, Dallas, Texas; Mayo Clinic, Rochester, Minnesota; and Children's Hospital, Boston, Massachusetts

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 May 04;93(Supplement 2):62-65. doi: 10.2106/JBJS.J.01769
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Abstract

Background: 

Venous thromboembolism, a known complication of orthopaedic procedures, is thought to be more prevalent following hip surgery. Venous thromboembolism risk assessment and appropriate prophylaxis according to the American College of Chest Physicians guidelines has become the standard of care. However, it is accepted that venous thromboembolism prophylaxis is associated with potential adverse sequelae including hematoma, wound drainage, and infection. Little is known regarding the incidence of venous thromboembolism following periacetabular osteotomy and the necessity for and method of routine prophylaxis.

Methods: 

A total of 1067 periacetabular osteotomies performed at six North American centers utilizing different methods of prophylaxis against venous thromboembolism were analyzed for type of prophylaxis and incidence of clinically symptomatic venous thromboembolism.

Results: 

There were four cases of pulmonary embolus and seven cases of deep vein thrombosis. There were no reported deaths. The crude incidence of clinically symptomatic venous thromboembolism was 9.4 per 1000 procedures.

Conclusions: 

The risk from chemoprophylaxis and the development of hematoma may be greater than the risk of clinically important venous thromboembolism in patients undergoing periacetabular osteotomy.

Level of Evidence: 

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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