American Academy of Orthopaedic Surgeons
View all recommendations from this societyReleased September 11, 2013
Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
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.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
How The List Was Created
(1–5) The American Academy of Orthopaedic Surgeons (AAOS) routinely develops evidence-based clinical practice guidelines as valuable tools to advance the physician-patient communications process and enhance the diagnosis and treatment of musculoskeletal conditions. AAOS physician volunteer work groups develop evidence-based clinical practice guidelines to serve as an educational tool based on an assessment of the current scientific and clinical information and accepted approaches to treatment. The most recent approved clinical practice guidelines have been published in the Journal of Bone and Joint Surgery. AAOS staff, led by the medical director, conducted a review of the approved clinical practice guidelines previously developed by the work groups and selected a variety of topics frequently used in orthopaedic surgical practice. After input from the orthopaedic specialty society leaders and approval from the AAOS Presidential Leadership and Board of Directors, the final five topics were selected for this campaign. The AAOS disclosure and conflict of interest policy can be found at www.aaos.org.
(6-10) The American Academy of Orthopaedic Surgeons (AAOS) routinely develops evidence-based clinical practice guidelines as valuable tools to advance the physician-patient communications process and enhance the diagnosis and treatment of musculoskeletal conditions. AAOS physician volunteer workgroups develop evidence-based clinical practice guidelines to serve as an educational tool based on an assessment of the current scientific and clinical information and accepted approaches to treatment. AAOS staff methodologists conducted a review of the approved clinical practice guidelines previously developed by the workgroups and selected a variety of topics frequently used in orthopaedic surgical practice. After input and approval from the AAOS Committee on Evidence-Based Quality and Value, followed by the approval from the AAOS, Council on Research and Quality and AAOS Board of Directors, the final five topics were selected for this campaign. The AAOS disclosure and conflict of interest policy can be found at www.aaos.org/quality.
Sources
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American Academy of Orthopaedic Surgeons. Clinical Practice Guideline on Preventing Venous Thromboembolic Disease in Patients Undergoing Elective Hip and Knee Arthroplasty. Rosemont (IL): American Academy of Orthopaedic Surgeons, 2011 Sep. Available from: http://www.aaos.org/research/guidelines/VTE/VTE_full_guideline.pdf.
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Robinson KS, Anderson DR, Gross M, Petrie D, Leighton R, Stanish W, Alexander D, Mitchell M, Flemming B, Gent M. 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.
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Westrich GH, Schneider R, Ghelman B, et al. Comparison between color Doppler imaging and ascending venography in the detection of deep venous thrombosis following total joint arthroplasty: a prospective study. Contemp Surg 1997;51:225-34.