Hippokratia 2010; 14(3):185-188
H. Mouravas, D. Verettas, K. Kazakos, K. Xarhas, N. Panagiotou, P. Ellinas
Backround: The role of hyperhomocysteinemia as an independent risk factor for venous thrombosis after lower limb arthroplasty remains questionable. The objective of this study is to determine the relationship between hyperhomocysteinemia and postoperative thromboembolic events in patients undergoing total hip or knee arthroplasty.
Method: Between September 2004 and June 2006, we studied 172 patients (41 male and 131 female) with mean age 70.2 years (48-85). Total plasma homocysteine as well as other thrombophilic agents (proteinC, protein S, Antithrombin III, Lupus anticoagulants, APC-Resistance) were measured preoperatively. Duplex sonography was performed twice postoperatively, on the 7th day (+/-2) and on the 42th day (+/- 2). Spiral CT was performed when pulmonary embolism was suspected.
Results: Four patients developed deep venous thrombosis from which two developed pulmonary embolism. Only one of these four patients had high levels of total plasma homocysteine.
Conclusions: Total plasma homocysteine does not seem to affect the development of deep venous thrombosis in patients undergoing total knee or hip arthroplasty and receive low molecular weight heparine.