A review of the evidence for and against thromboprophylaxis in total hip replacement
Published online: Oct 27 2011
Mahiben MARUTHAPPU, Myura NAGENDRAN, Kapil SUGAND, Christopher K. BULSTRODE
From Oxford University & St George's NHS Healthcare Trusts, U.K.
Abstract
Deep vein thrombosis (DVT) after an unprotected total hip replacement (THR) is common and this review explores the balance between risks and benefits of thrombo-prophylaxis in protecting patients undergoing THR.
A literature search for English publications was conducted on Medline & PubMed. Governance bodies and their guidelines were consulted. MESH terms included Deep Vein Thrombosis OR DVT AND Prophylaxis AND Hip AND/OR Surgery AND/OR Total Replacement OR Arthroplasty.
THR results in significant risk of thrombo-embolic complications with studies showing that as many as one half of patients suffer from DVT post-operatively. Prophylactic treatments are used to reduce the incidence of DVT. However, there are also risks associated with the use of prophylaxis, including excessive bleeding and major cardio-vascular events. Further investigation is required to determine which patients should be given what prophylaxis and for how long post THR.