Thromboprophylaxis after total hip replacement

The risk of secondary haematologic complications such as deep vein thrombosis or pulmonary embolism increases significantly when a transient period of hypercoagulability is induced after total hip replacement (THR). A number of drug-based anticoagulant approaches are available to modulate this risk, but the optimal length of therapy for such approaches remains unclear. The literature was reviewed for evidence-based support of the routine use of an extended course (>14 days) of thromboprophylaxis after THR. Electronic databases and real-time online literature searches were performed, using the PubMed (Medline), EMBASE, CINAHL and GoogleScholar, and the Cochrane and British Medical Journal Clinical Evidence libraries. Author-defined key word searches were performed. Only articles in the English language, for which full text could be retrieved, were reviewed. There is robust evidence to support an extended course (>14 days) of thromboprophylaxis after THR. Such recommendations have been translated into the guidelines of key professional bodies, including those of the American College of Chest Physicians. MetaReview article: Thromboprophylaxis after total hip replacement Andrew P Kurmis1,2 1 Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia 2 School of Medicine, Flinders University, Bedford Park, South Australia, Australia Address correspondence and reprint requests to: Dr Andrew P Kurmis, Department of Orthopaedic Surgery (L7 East), Royal Melbourne Hospital, Grattan Street, Parkville, Victoria, 3050, Australia. E-mail: [email protected] Journal of Orthopaedic Surgery 2010;18(1):92-7 review suggests a clear benefit of such regimens and supports wider adoption, even when weighed against a small increase in adverse events.