Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 26637
CURRENT MANAGEMENT OF RISK FACTORS IN PATIENTS UNDERGOING
TOTAL HIP AND KNEE ARTHROPLASTY IN WALES
Karadi Hari SUNIL KUMAR 1 , Alexander DODDS 2
1 Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry (UNITED KINGDOM),
2 Queen Elizabeth I I Hospital, Welwyn Garden City (UNITED KINGDOM)
Introduction: Total Knee and Hip Arthroplasty (TKA and THA respectively) are two of
the most commonly performed surgical operations. Two of the major risks for patients
undergoing TKA or THA are deep vein thrombosis (DVT) and infection. Aim: To
assess the current use of antibiotic prophylaxis and DVT prophylaxis for patients
undergoing THA or TKA in Wales. Methods: We used a telephone questionnaire to
collect data from every Hospital in Wales regarding the number of joint replacement
surgeons, their choice of antibiotic and DVT prophylaxis. Results: TKA or THA were
performed in thirteen hospitals. In smaller district general hospital most general
orthopaedic surgeons carried out TKA or THA, whereas in the larger units specialist
surgeons performed the same. The preferred antibiotic prophylaxis was cefuroxime
1.5grams (g) at induction and 2 post op doses of 0.75g although the dosage varied.
All hospitals used laminar air flow theatres. We found that DVT prophylaxis varied
much more, ranging from TED stockings and aspirin to foot pumps during hospital
stay and enoxaparin for four weeks post-op. Two hospitals used tinzaparin instead of
enoxaparin and one used fondaparinux sodium. Conclusion: The current
management of risk factors in TKA or THA patients in Wales varied significantly.
Although antibiotic prophylaxis seems to be uniform there is a slight dose variation.
However, this practice is not necessarily evidence based. The DVT prophylaxis
regime varied much more and seems to depend on the individual surgeon’s
preference despite the recent publication of guidelines from NICE.
288