What Should I Prioritize: Orthopedic Surgery or Vein Treatment?

Are you considering total knee or hip replacement? You might want to consider treating your varicose veins first.

Many older adults deal with orthopedic ailments such as osteoarthritis in addition to vein disease. In some cases, damage to the hip or knee requires a total replacement of the joint. Fortunately, joint replacement surgeries are effective and safe. But if you also have varicose veins, should you prioritize treating the swollen veins before total hip or knee replacement? According to one study, the answer is yes. Of course, you should always consult your doctor first before making this decision.

Hip and knee replacement surgeries require a hospital stay and a recovery period that limits mobility. Immobility increases the risk of a blood clot or deep vein thrombosis (DVT) developing in the legs. If that clot dislodges from the leg vein, it could travel to the lungs, potentially causing a life-threatening pulmonary embolism (PE). Having varicose veins further increases the risk of DVT. Therefore, you might want to speak to your doctor about addressing your vein disease before undergoing orthopedic surgery.

Elevated Risk of DVT After Hip Replacement

A 2012 study reported patients with untreated varicose veins had a statistically significant 3.1 percent higher rate of DVT after undergoing a total hip replacement. However, researchers found no difference in DVT and untreated varicose veins in those undergoing a total knee replacement. There was also no evidence of an elevated risk of PE in patients with no history of varicose vein treatment and total hip replacement.

Nevertheless, treating your varicose veins before an extensive orthopedic operation may be warranted. A study done in Taiwan found patients with varicose veins showed an increased chance of developing DVT. Combined with the potential for DVT after total hip replacement surgery, untreated varicose veins may see double the risk of a blood clot after the operation.

Treat Your Varicose Veins First

A vein specialist can discuss your varicose vein treatment options before undergoing an orthopedic surgery. Current surgical therapies for varicose veins are quick and minimally invasive with short recovery periods. Therefore, having varicose vein treatment shouldn’t delay your orthopedic procedure for too long.

Depending on the size and location of your varicose veins, your vein specialist will recommend one or more in-office procedures, including sclerotherapy or thermal ablation. During sclerotherapy, a safe solution is injected into the damaged vein, causing it to collapse and eventually be reabsorbed. The heat generated by a laser or radiofrequency waves is pulsed into the vein via a catheter during a thermal ablation procedure. The varicose vein then seals and the blood is rerouted to healthier veins. Larger varicose veins may be treated with ambulatory phlebectomy. In that procedure, the enlarged veins are removed through two tiny incisions.

That said, caring for your veins doesn’t necessarily mean surgery. Self-care remedies that exercise the calf muscles are the first line of defense. Walking and bike riding, elevating your legs, and wearing compression stockings can help prevent varicose veins from forming or reduce painful swelling and cramping.

Those same at-home measures also reduce the risk of DVT. Moving about periodically or simply flexing your ankles during long hours sitting at work or on a plane trip keeps the blood flowing and lessens the chance of a clot developing. Wearing compression stockings, even without experiencing varicose veins symptoms, helps maintain blood flow and reduces DVT risk during long periods of inactivity. After your orthopedic surgery, your doctor may recommend many of those measures to prevent DVT.

Let Us Treat Your Veins

If you’re considering orthopedic surgery and have varicose veins, consult with one of the physicians at our five clinics in New Mexico before surgery. Dr. Chandran Vedamanikam, MD, is board-certified in Venous and Lymphatic Medicine (Phlebologist) and Family Practice. Dr. Michael Harding, MD, is board-certified in Vascular Medicine, Cardiology, and Internal Medicine. Both doctors bring years of experience in treating vein disorders and are caring, compassionate physicians. Contact them today.

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Albuquerque, NM 87102

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Deming, NM 88030

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Las Cruces, NM 88011

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Rio Rancho, NM 87124

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Truth Or Consequences, NM 87901