Award-Winning Study by Dr. Westrich Shows Genetic Predisposition to Blood Clots
(New York, N.Y. March 24, 2005). An award-winning study by Dr. Geoffrey Westrich and doctors at the Hospital for Special Surgery in New York City has identified genetic variations that make people vulnerable to developing a blood clot after hip replacement surgery. "We undertook the study because blood clots are a potentially life-threatening complication following total hip replacement," said orthopedic surgeon Geoffrey Westrich. "The study findings are important because if we can identify high-risk patients before they have the operation, measures can be taken to prevent blood clots and save lives." About 200,000 Americans undergo hip replacement each year.
The research paper, titled, "Heritable Thrombophilia and Development of Thromboembolic Disease Following Total Hip Arthroplasty," was awarded The Hip Society's prestigious John Charnley Award, which recognizes innovative research encompassing important advances in the management of hip disorders. Thromboembolic disease refers to blood clots; total hip arthroplasty means total hip replacement.
People undergoing joint replacement are at risk of deep-vein thrombosis (DVT), which occurs when a blood clot forms in a deep vein, usually in the leg. DVT becomes life-threatening if part of the clot breaks off and travels through the bloodstream to the lungs, causing a condition known as a pulmonary embolism.
In the study, Dr. Westrich and his colleagues used advanced genetic testing and discovered that patients who developed DVT after total hip replacement had certain genetic markers that increased risk. More specifically, researchers compared the test results of 43 patients diagnosed with DVT to a control group of 43 patients without DVT and found three genetic mutations in individuals who had developed a blood clot.
As a result of the study, Dr. Westrich has started to use the genetic screening for patients prior to hip replacement if they come in with other risk factors. Non-genetic risk factors include advanced age, obesity, cardiovascular disease, diabetes, cancer and smoking. Treatments such as compression stockings to improve leg circulation and anticoagulant drugs can prevent blood clots and reduce the DVT rate significantly.
"In the future, with refinements in genetic screening and increased availability of these tests, we will be able to identify susceptible individuals on a larger scale. Once high-risk patients are identified, appropriate preventive measures can be taken to avert this life-threatening problem," Dr. Westrich says.