Naples, Italy
Authors from the University of Naples, Italy have pubslished an interesting artice regarding the usefulness of performing prophylactic ablation of the great saphenous vein or prophylactic stripping of the great saphenous vein in patients undergoing elective total knee or total hip arthroplasty.
The lead author of the manuscript in Open Medicine is Dr Gennaro Quatro. Other authors include Bruno Amato, Giacomo Benassai, Marco Apperti, Antonio Sellitti, Luigi Sivero and Ermenegildo Furino.
This was a etrospective study enrolling 44 patients over the age of 65 undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Twenty four underwent vein stripping of the GSV and 20 patients underwent endovenous laser ablation of the great saphenous vein.
The presence of evident varicosities and/or saphenofemoral reflux > 500 ms has been considered as operability criterion.
Of the 44 patients studied, one patient developed symptomatic DVT after arthroplasty. The authors noted a statistically significant difference (p = 0.006) of recovery time between surgery and EVLA groups with endovenous laser ablation patients recovering quicker.
The researchers from the University of Naples conclude that GSV ablation or stripping is udeful before elective hip or knee arthroplasty. They also showed a 50% decrease in the incidence of postoperative DVT.
Dr. Karamanoukian's notes: This is an interesting study that should be verified by larger studies as the occurence of venous insufficiency is high among patients undergoing total hip or total knee arthroplasty.
The study is available on Open Medicine as an open source publication at the link shown below; https://www.degruyter.com/view/j/med.2016.11.issue-1/med-2016-0083/med-2016-0083.xml
Key words from the article are : Hip Replacement Arthroplasties; Knee Replacement Arthroplasties; Deep Vein Thrombosis; Varicose Vein; Saphenous Vein; GSV; EVLA; Aging; Frail Elderly