Can clinical findings predict the complications associated with acute-phase deep venous thrombosis after total hip arthroplasty?

[Purpose] The purpose of this study was to investigate whether clinical findings can be used to predict lower extremity complications associated with deep venous thrombosis (DVT) after total hip arthroplasty (THA). [Subjects and Methods] In all, 37 female patients (mean age, 63.4 ± 10.2 years) with osteoarthritis of the hip who had undergone THA were included in this study. We evaluated pain (Homans sign or tenderness) and edema on the postoperative day when physical therapy was restarted. [Results] Venography revealed that 12 patients had DVT (group D) and 25 patients did not (group N). The intensity of calf pain was significantly higher in group D than in group N. The positive predictive value of pain for DVT was 62.5%, and the negative predictive value of pain was 75.9% (sensitivity, 41.7%; specificity, 88.0%). Patients with proximal DVT tended to have fewer clinical findings than those with distal DVT. [Conclusion] These results suggest that clinical findings are more apparent in patients with DVT; however, proximal DVT would be overlooked because it has few clinical findings.