Introduction

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are serious complications that can occur after full hip arthroplasty (FHA), commonly known as full hip replacement (FHR). This project investigates the risk factors associated with DVT and PE following FHA, focusing on preventative measures and diagnostic techniques that protect patient health. We will explore current practices in the United States, Europe, and China, emphasising regional differences and recent advancements in managing these potentially life-threatening conditions. Additionally, we will consider the role of evolving technology, pharmacology, and nutritional approaches in enhancing patient outcomes and minimising complications.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) Post-Full Hip Arthroplasty (FHA):

Overview and Pathophysiology:
- DVT as a Precursor to PE: Deep Vein Thrombosis (DVT) occurs when a blood clot forms in the deep veins, typically in the legs. If a portion of this clot breaks loose, it can travel through the bloodstream to the lungs, resulting in a pulmonary embolism (PE). PE is a severe complication that can impair oxygen exchange, lead to right heart strain, and potentially cause death.
- Post-FHA Risk: Patients undergoing Full Hip Arthroplasty (FHA) or Full Hip Replacement (FHR) are particularly susceptible to DVT due to prolonged immobility, direct trauma to blood vessels during surgery, and the body's natural response to surgical stress, which includes increased coagulation. Reduced mobility after the surgery exacerbates venous stasis, creating an environment conducive to clot formation.

Methods of DVT Prophylaxis and Detection:
- Mechanical Methods:
- Passive Pressure Methods (Compression Stockings):
- Mechanism: Compression stockings apply graded pressure, most intense at the ankle, decreasing as it goes up the leg. This compression helps promote venous return, reducing blood pooling in the lower extremities.
- Usage: Widely utilised across the United States, Europe, and China, especially in patients at moderate risk for DVT following FHA.
- Effectiveness: While generally effective, patient compliance can be an issue due to the discomfort or difficulty in applying these stockings, particularly in elderly or less mobile patients.
- Active Pressure Methods (Intermittent Pneumatic Compression - IPC):
- Mechanism: IPC devices involve inflatable cuffs that periodically inflate and deflate around the legs, simulating the natural pumping action of muscles to enhance venous return and minimise stasis.
- Usage: Commonly employed in hospitals in the US and Europe, particularly for high-risk FHA patients. In China, their use is growing, especially in urban hospitals with advanced resources.
- Effectiveness: IPC devices are highly effective, particularly when used soon after surgery and in combination with pharmacological prophylaxis.