Knee and Hip Replacement Surgery: The Risk of Blood Clots

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Deep vein thrombosis (DVT) is the most common form of blood clots that occur after total hip replacement and total knee replacement surgery, as well as after a broken hip. Patients who have these surgeries typically remain inactive for a period of many days or weeks after the surgery takes place. This inactivity can cause blood flow to slow down in the deep veins of the legs, forming potentially dangerous clots.

As many as 40% of patients who don’t receive treatment to prevent clotting after these surgeries will develop DVT within one to two weeks after surgery, according to the U.S. Department of Health and Human Services. For patients considering hip or knee replacement, it’s important to understand how and why blood clots and what preventative treatments are available.

What are blood clots?

Blood clots typically form when a blood vessel is injured in some way, causing bleeding. When that occurs, blood cells bond together and form a clot that blocks the flow of blood. These clots are made of blood cells, sticky cells called platelets that speed the clotting process, and a protein known as fibrin that forms a fibrous mesh to trap cells.

Clots are beneficial when they stop bleeding at the site of a cut or other injury. However, they can also form when poor circulation causes blood to slow and pool in the deep veins. These clots block the flow of blood and can cause pain, swelling and irritation in the affected limb. They can also break free and travel to other parts of the body, causing damage in the brain, heart, and lungs.

What are the treatment options?

Inactivity after a major surgery can lead to the conditions—like poor circulation—that raise the risk of DVT. Talk to your doctor about DVT before having your hip or knee replaced. Be sure to tell them about any risk factors for DVT you may have such as prior history of DVT, smoking, obesity, or if you are taking birth control or hormone replacement therapies.

Your doctor may prescribe a number of treatments including prophylaxis medication that keep clots from forming.

There are also a number of medical devices your doctor can prescribe, including compression socks that squeeze the legs to increase blood flow. Your physician may also prescribe pneumatic compression devices that go over your leg or foot. The device is slowly inflated and deflated to keep your blood moving at any time of day or night.

DVT can cause additional pain and swelling, hinder your recovery, and cause lasting complications even when you’ve fully recovered from surgery. But prevention and taking precautions when it comes to DVT risk can help reduce your risk of clotting after surgery by up to four times.