The Journal of Arthroplasty
Volume 27, Issue 5 , Pages 730-735, May 2012

A Pilot Study of Computed Tomography–Detected Asymptomatic Pulmonary Filling Defects After Hip and Knee Arthroplasties

  • Rajiv Gandhi, MS, MD

      Affiliations

    • Toronto Western Hospital, Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests: Rajiv Gandhi, MS, MD, Toronto Western Hospital, 399 Bathurst St, EW 1-439, Toronto, Ontario M5T 2S8, Canada.
    • ,
  • David Salonen, MD

      Affiliations

    • Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
    • ,
  • William H. Geerts, MD

      Affiliations

    • Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Monica Khanna, MRCS, FRCR

      Affiliations

    • Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Sean McSweeney, MB, BCH, BAO, FFRRCS

      Affiliations

    • Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Nizar N. Mahomed, MD, ScD

      Affiliations

    • Division of Orthopedic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada

Received 11 July 2011; accepted 17 October 2011. published online 19 December 2011.

Abstract 

We asked what the incidence of asymptomatic filling defects is on routine multidetector computed tomography (MDCT) in primary hip (total hip arthroplasty [THA]) and knee arthroplasties (TKA) patients. We prospectively performed MDCT scans on the first postoperative day for THA (n = 21)/TKA (n = 27). Patients underwent routine postoperative care, and data were collected for symptoms such as tachycardia or shortness of breath. More patients undergoing TKA had positive computed tomography scans than those undergoing THA: 11 (41%) vs 1 (5%), respectively. All patients diagnosed with a filling defect were discharged from the hospital without treatment of symptomatic pulmonary embolism. Our study demonstrates a high rate of abnormal MDCT early after lower extremity arthroplasty, the clinical importance of which may be benign.

Keywords: pulmonary embolism, hip arthroplasty, knee arthroplasty

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 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.10.019.

PII: S0883-5403(11)00567-5

doi:10.1016/j.arth.2011.10.019

The Journal of Arthroplasty
Volume 27, Issue 5 , Pages 730-735, May 2012

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