Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1975 Jun;181(6):896–901. doi: 10.1097/00000658-197506000-00025

A comparative analysis of warfarin and low-dose heparin as thromboembolism prophylaxis in total hip replacement patinets.

M A Ritter, HamiltonCW
PMCID: PMC1343916  PMID: 1138642

Abstract

Warfarin, low-dose heparin, or a combination of low-dose heparin and hydrocortisone was administered to 300 patients undergoing total hip replacement. The lowest incidence of thromboembolic (5 per cent) was attained with Warfarin. Further investigation into the method of administration of low-dose heparin is necessary before it can be used effectively as thromboembolism prophylaxis in total hip replacement patients. The addition of hydrocortisone was not found useful.

Full text

PDF
900

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonnar J., Denson K. W., Biggs R. Subcutaneous heparin and prevention of thrombosis. Lancet. 1972 Sep 9;2(7776):539–540. doi: 10.1016/s0140-6736(72)91933-2. [DOI] [PubMed] [Google Scholar]
  2. CHAKRABARTI R., FEARNLEY G. R., HOCKING E. D. EFFECT OF CORTICOSTEROID THERAPY ON FIBRINOLYSIS IN PATIENTS WITH INFLAMMATORY AND NON-INFLAMMATORY CONDITIONS. Br Med J. 1964 Feb 29;1(5382):534–537. doi: 10.1136/bmj.1.5382.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Castle M. E., Orinion E. A. Prophylactic anticoagulation in fractures. J Bone Joint Surg Am. 1970 Apr;52(3):521–528. [PubMed] [Google Scholar]
  4. Charnley J. Prophylaxis of postoperative thromboembolism. Lancet. 1972 Jul 15;2(7768):134–135. doi: 10.1016/s0140-6736(72)91620-0. [DOI] [PubMed] [Google Scholar]
  5. Coventry M. B., Nolan D. R., Beckenbaugh R. D. "Delayed" prophylactic anticoagulation: a study of results and complications in 2,012 total hip arthroplasties. J Bone Joint Surg Am. 1973 Oct;55(7):1487–1492. [PubMed] [Google Scholar]
  6. Crummy C. S., Perlin E., Moquin R. B. Microangiopathic hemolytic anemia in Wegener's granulomatosis. Am J Med. 1971 Oct;51(4):544–548. doi: 10.1016/0002-9343(71)90259-2. [DOI] [PubMed] [Google Scholar]
  7. Culver D., Crawford J. S., Gardiner J. H., Wiley A. M. Venous thrombosis after fractures of the upper end of the femur. A study of incidence and site. J Bone Joint Surg Br. 1970 Feb;52(1):61–69. [PubMed] [Google Scholar]
  8. DINES D. E. POLYARTERITIS NODOSA. REPORT OF A PATIENT RECEIVING LONG-TERM ANTICOAGULANT THERAPY. JAMA. 1964 Jul 13;189:156–158. [PubMed] [Google Scholar]
  9. Eika C., Godal H. C., Kierulf P. Detection of small amounts of heparin by the thrombin clotting-time. Lancet. 1972 Aug 19;2(7773):376–376. doi: 10.1016/s0140-6736(72)91754-0. [DOI] [PubMed] [Google Scholar]
  10. Evanski P. M., Waugh T. R., Orofino C. F. Total hip replacement with the Charnley prosthesis. Clin Orthop Relat Res. 1973 Sep;(95):69–72. [PubMed] [Google Scholar]
  11. Evarts C. M., Alfidi R. J. Thromboembolism after total hip reconstruction. Failure of low doses of heparin in prevention. JAMA. 1973 Jul 30;225(5):515–516. [PubMed] [Google Scholar]
  12. Evarts C. M., Feil E. J. Prevention of thromboembolic disease after elective surgery of the hip. J Bone Joint Surg Am. 1971 Oct;53(7):1271–1280. [PubMed] [Google Scholar]
  13. Field E. S., Nicolaides A. N., Kakkar V. V., Crellin R. Q. Deep-vein thrombosis in patients with fractures of the femoral neck. Br J Surg. 1972 May;59(5):377–379. doi: 10.1002/bjs.1800590512. [DOI] [PubMed] [Google Scholar]
  14. Flanc C., Kakkar V. V., Clarke M. B. Postoperative deep-vein thrombosis. Effect of intensive prophylaxis. Lancet. 1969 Mar 8;1(7593):477–478. doi: 10.1016/s0140-6736(69)91585-2. [DOI] [PubMed] [Google Scholar]
  15. Flanc C., Kakkar V. V., Clarke M. B. The detection of venous thrombosis of the legs using 125-I-labelled fibrinogen. Br J Surg. 1968 Oct;55(10):742–747. doi: 10.1002/bjs.1800551007. [DOI] [PubMed] [Google Scholar]
  16. Gallus A. S., Hirsh J., Tutle R. J., Trebilcock R., O'Brien S. E., Carroll J. J., Minden J. H., Hudecki S. M. Small subcutaneous doses of heparin in prevention of venous thrombosis. N Engl J Med. 1973 Mar 15;288(11):545–551. doi: 10.1056/NEJM197303152881103. [DOI] [PubMed] [Google Scholar]
  17. Gordonaasmith I. C., Grundy D. J., Lequesne L. P., Newcombe J. F., Bramble F. J. Controlled trial of two regimens of subcutaneous heparin in prevention of postoperative deep-vein thrombosis. Lancet. 1972 May 27;1(7761):1133–1135. [PubMed] [Google Scholar]
  18. Hamilton H. W., Crawford J. S., Gardiner J. H., Wiley A. M. Venous thrombosis in patients with fracture of the upper end of the femur. A phlebographic study of the effect of prophylactic anticoagulation. J Bone Joint Surg Br. 1970 May;52(2):268–289. [PubMed] [Google Scholar]
  19. Harris W. H., Salzman E. W., DeSanctis R. W., Coutts R. D. Prevention of venous thromboembolism following total hip replacement. Warfarin vs dextran 40. JAMA. 1972 Jun 5;220(10):1319–1322. [PubMed] [Google Scholar]
  20. Harris W. H., Salzman E. W., Desanctis R. W. The prevention of thromboembolic disease by prophylactic anticoagulation. A controlled study in elective hip surgery. J Bone Joint Surg Am. 1967 Jan;49(1):81–89. [PubMed] [Google Scholar]
  21. Isacson S. Low fibrinolytic activity of blood and vein walls in venous thrombosis. Scand J Haematol Suppl. 1971;16:1–29. doi: 10.1111/j.1600-0609.1971.tb02062.x. [DOI] [PubMed] [Google Scholar]
  22. Johnston R. C. Clinical follow-up of total hip replacement. Clin Orthop Relat Res. 1973 Sep;(95):118–126. [PubMed] [Google Scholar]
  23. Johnston R. C., Larson C. B. Results of treatment of hip disorders with cup arthroplasty. J Bone Joint Surg Am. 1969 Dec;51(8):1461–1479. [PubMed] [Google Scholar]
  24. Kakkar V. V., Corrigan T., Spindler J., Fossard D. P., Flute P. T., Crellin R. Q., Wessler S., Yin E. T. Efficacy of low doses of heparin in prevention of deep-vein thrombosis after major surgery. A double-blind, randomised trial. Lancet. 1972 Jul 15;2(7768):101–106. doi: 10.1016/s0140-6736(72)91595-4. [DOI] [PubMed] [Google Scholar]
  25. Kakkar V. V., Field E. S., Nicolaides A. N., Flute P. T. Low doses of heparin in prevention of deep-vein thrombosis. Lancet. 1971 Sep 25;2(7726):669–671. doi: 10.1016/s0140-6736(71)92244-6. [DOI] [PubMed] [Google Scholar]
  26. Kakkar V. V., Howe C. T., Nicolaides A. N., Renney J. T., Clarke M. B. Deep vein thrombosis of the leg. Is there a "high risk" group? Am J Surg. 1970 Oct;120(4):527–530. doi: 10.1016/s0002-9610(70)80023-x. [DOI] [PubMed] [Google Scholar]
  27. Lahnborg G., Bergström K., Friman L., Lagergren H. Effect of low-dose heparin on incidence of postoperative pulmonary embolism detected by photoscanning. Lancet. 1974 Mar 2;1(7853):329–331. doi: 10.1016/s0140-6736(74)93076-1. [DOI] [PubMed] [Google Scholar]
  28. Langenskiöld A., Paavilainen T. Total replacement of 116 hips by the McKee-Farrar prosthesis. A preliminary report. Clin Orthop Relat Res. 1973 Sep;(95):143–150. [PubMed] [Google Scholar]
  29. Moczynski G., Abraham E., Barmada R., Ray R. D. Evaluation of total hip replacement arthroplasties. Clin Orthop Relat Res. 1973 Sep;(95):213–216. [PubMed] [Google Scholar]
  30. NEU L. T., Jr, WATERFIELD J. R., ASH C. J. PROPHYLACTIC ANTICOAGULANT THERAPY IN THE ORTHOPEDIC PATIENT. Ann Intern Med. 1965 Mar;62:463–467. doi: 10.7326/0003-4819-62-3-463. [DOI] [PubMed] [Google Scholar]
  31. Nicolaides A. N., Dupont P. A., Desai S., Lewis J. D., Douglas J. N., Dodsworth H., Fourides G., Luck R. J., Jamieson C. W. Small doses of subcutaneous sodium heparin in preventing deep venous thrombosis after major surgery. Lancet. 1972 Oct 28;2(7783):890–893. doi: 10.1016/s0140-6736(72)92531-7. [DOI] [PubMed] [Google Scholar]
  32. Patterson F. P., Brown C. S. The McKee-Farrar total hip replacement. Preliminary results and complications of 368 operations performed in five general hospitals. J Bone Joint Surg Am. 1972 Mar;54(2):257–275. [PubMed] [Google Scholar]
  33. Pinto D. J. Controlled trial of an anticoagulant (warfarin sodium) in the prevention of venous thrombosis following hip surgery. Br J Surg. 1970 May;57(5):349–352. doi: 10.1002/bjs.1800570508. [DOI] [PubMed] [Google Scholar]
  34. Ring P. A. Complete replacement arthroplasty of the hip by the ring prosthesis. J Bone Joint Surg Br. 1968 Nov;50(4):720–731. [PubMed] [Google Scholar]
  35. Rosengarten D. S., Laird J. The effect of leg elevation on the incidence of deep-vein thrombosis after operation. Br J Surg. 1971 Mar;58(3):182–184. doi: 10.1002/bjs.1800580307. [DOI] [PubMed] [Google Scholar]
  36. Rothermel J. E., Wessinger J. B., Stinchfield F. E. Dextran 40 and thromboembolism in total hip replacement surgery. Arch Surg. 1973 Feb;106(2):135–137. doi: 10.1001/archsurg.1973.01350140003003. [DOI] [PubMed] [Google Scholar]
  37. Rowell N. R., Cotterill J. A. Relapsing polychondritis. Br J Dermatol. 1973 Apr;88(4):387–390. doi: 10.1111/j.1365-2133.1973.tb07570.x. [DOI] [PubMed] [Google Scholar]
  38. SEVITT S., GALLAGHER N. G. Prevention of venous thrombosis and pulmonary embolism in injured patients. A trial of anticoagulant prophylaxis with phenindione in middle-aged and elderly patients with fractured necks of femur. Lancet. 1959 Dec 5;2(7110):981–989. doi: 10.1016/s0140-6736(59)91464-3. [DOI] [PubMed] [Google Scholar]
  39. SEVITT S., GALLAGHER N. Venous thrombosis and pulmonary embolism. A clinico-pathological study in injured and burned patients. Br J Surg. 1961 Mar;48:475–489. doi: 10.1002/bjs.18004821103. [DOI] [PubMed] [Google Scholar]
  40. SEVITT S. Venous thrombosis and pulmonary embolism. Their prevention by oral anticoagulants. Am J Med. 1962 Nov;33:703–716. doi: 10.1016/0002-9343(62)90248-6. [DOI] [PubMed] [Google Scholar]
  41. SHARNOFF J. G., KASS H. H., MISTICA B. A. A plan of heparinization of the surgical patient to prevent postoperative thromboembolism. Surg Gynecol Obstet. 1962 Jul;115:75–79. [PubMed] [Google Scholar]
  42. Sharnoff J. G., DeBlasio G. Prevention of fatal postoperative thromboembolism by heparin prophylaxis. Lancet. 1970 Nov 14;2(7681):1006–1007. doi: 10.1016/s0140-6736(70)92815-1. [DOI] [PubMed] [Google Scholar]
  43. Sharnoff J. G. Prevention of thromboembolism. Bull N Y Acad Med. 1973 Aug;49(8):655–660. [PMC free article] [PubMed] [Google Scholar]
  44. Sharnoff J. G. Results in the prophylaxis of postoperative thromboembolism. Surg Gynecol Obstet. 1966 Aug;123(2):303–307. [PubMed] [Google Scholar]
  45. Wessler S., Yin E. T. Theory and practice of minidose heparin in surgical patients. A status report. Circulation. 1973 Apr;47(4):671–676. doi: 10.1161/01.cir.47.4.671. [DOI] [PubMed] [Google Scholar]
  46. Williams H. T. Prevention of postoperative deep-vein thrombosis with perioperative subcutaneous heparin. Lancet. 1971 Oct 30;2(7731):950–952. doi: 10.1016/s0140-6736(71)90270-4. [DOI] [PubMed] [Google Scholar]
  47. Wilson P. D., Jr, Amstutz H. C., Czerniecki A., Salvati E. A., Mendes D. G. Total hip replacement with fixation by acrylic cement. A preliminary study of 100 consecutive McKee-Farrar prosthetic replacements. J Bone Joint Surg Am. 1972 Mar;54(2):207–236. [PubMed] [Google Scholar]
  48. Yin E. T., Wessler S. Evidence for a naturally occurring plasma inhibitor of activated factor X: its isolation and partial purification. Thromb Diath Haemorrh. 1969 Apr 30;21(2):398–401. [PubMed] [Google Scholar]
  49. Yin E. T., Wessler S., Stoll P. J. Biological properties of the naturally occurring plasma inhibitor to activated factor X. J Biol Chem. 1971 Jun 10;246(11):3703–3711. [PubMed] [Google Scholar]
  50. Yin E. T., Wessler S., Stoll P. J. Rabbit plasma inhibitor of the activated species of blood coagulation factor X. Purification and some properties. J Biol Chem. 1971 Jun 10;246(11):3694–3702. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES