Since ultrasound is not effective at diagnosing unsuspected deep vein thrombosis (DVT) and appropriate alternative screening tests do not exist, if there is no change in the patient's clinical status, routine post-operative screening for DVT after hip or knee arthroplasty does not change outcomes or clinical management.

Conditions: Deep Vein Thrombosis (DVT), Hip Durgery, Knee Arthroplasty

Diagnostic Tests: Lower Extremity Venous Ultrasound

Sources

• Abraham P, Ternisien C, Hubert L, Pidhorz L, Saumet JL. Does venous microemboli detection add to the interpretation of D-dimer values following orthopedic surgery? Ultrasound Med Biol. 1999 May;25(4):637-40. (PubMed)
• American Academy of Orthopaedic Surgeons. Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty: Evidence-based guideline and evidence report. 2011 Sep [cited 2014 Feb 20]. (PDF)
• Bounameaux H, Miron MJ, Blanchard J, de Moerloose P, Hoffmeyer P, Leyvraz PF. Measurement of plasma D-dimer is not useful in the prediction or diagnosis of postoperative deep vein thrombosis in patients undergoing total knee arthroplasty. Blood Coagul Fibrinolysis. 1998 Nov;9(8):749-52. (PubMed)
• Ciccone WJ,2nd, Fox PS, Neumyer M, Rubens D, Parrish WM, Pellegrini VD,Jr. Ultrasound surveillance for asymptomatic deep venous thrombosis after total joint replacement. J Bone Joint Surg Am. 1998 Aug;80(8):1167-74. (PubMed)
• Davidson BL, Elliott CG, Lensing AW. Low accuracy of color Doppler ultrasound in the detection of proximal leg vein thrombosis in asymptomatic high-risk patients. The RD heparin arthroplasty group. Ann Intern Med. 1992 Nov 1;117(9):735-8. (PubMed)
• Garino JP, Lotke PA, Kitziger KJ, Steinberg ME. Deep venous thrombosis after total joint arthroplasty. The role of compression ultrasonography and the importance of the experience of the technician. J Bone Joint Surg Am. 1996 Sep;78(9):1359-65. (PubMed)
• Larcom PG, Lotke PA, Steinberg ME, Holland G, Foster S. Magnetic resonance venography versus contrast venography to diagnose thrombosis after joint surgery. Clin Orthop Relat Res. 1996 Oct;(331)(331):209-15. (PubMed)
• Lensing AW, Doris CI, McGrath FP, Cogo A, Sabine MJ, Ginsberg J, et al. A comparison of compression ultrasound with color Doppler ultrasound for the diagnosis of symptomless postoperative deep vein thrombosis. Arch Intern Med. 1997 Apr 14;157(7):765-8. (PubMed)
• Mont MA, Jacobs JJ, Boggio LN, Bozic KJ, Della Valle CJ, Goodman SB, et al. Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Am Acad Orthop Surg. 2011 Dec;19(12):768-76. (PubMed)
• Niimi R, Hasegawa M, Sudo A, Shi D, Yamada T, Uchida A. Evaluation of soluble fibrin and D-dimer in the diagnosis of postoperative deep vein thrombosis. Biomarkers. 2010 Mar;15(2):149-57. (PubMed)
• Pellegrini VD,Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. The John Charnley Award: Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res. 2005 Dec;441:56-62. (PubMed)
• Pellegrini VD,Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. The Mark Coventry Award: Prevention of readmission for venous thromboembolism after total knee arthroplasty. Clin Orthop Relat Res. 2006 Nov;452:21-7. (PubMed)
• Robinson KS, Anderson DR, Gross M, Petrie D, Leighton R, Stanish W, et al. Ultrasonographic screening before hospital discharge for deep venous thrombosis after arthroplasty: The post-arthroplasty screening study. A randomized, controlled trial. Ann Intern Med. 1997 Sep 15;127(6):439-45. (PubMed)
• Schmidt B, Michler R, Klein M, Faulmann G, Weber C, Schellong S. Ultrasound screening for distal vein thrombosis is not beneficial after major orthopedic surgery. A randomized controlled trial. Thromb Haemost. 2003 Nov;90(5):949-54. (PubMed)
• Westrich GH, Schneider R, Ghelman B, Derkowska I, Tarantino SJ, Ranawat C, Sculco TP. The incidence of deep venous thrombosis with color Doppler imaging compared to ascending venography in total joint arthroplasty: A prospective study. Contemp Surg. 1997;51:225-34. (ChoosingWisely)