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. 1991 Jul 27;303(6796):219–220. doi: 10.1136/bmj.303.6796.219

Efficacy of fixed minidose warfarin prophylaxis in total hip replacement.

M J Fordyce 1, A S Baker 1, G E Staddon 1
PMCID: PMC1670497  PMID: 1884058

Abstract

OBJECTIVE--To determine whether a small fixed perioperative dose of warfarin would prevent deep vein thrombosis after total hip replacement. DESIGN--Prospective, randomised, double blind placebo controlled trial. SETTING--Winford Orthopaedic Hospital, Bristol. SUBJECTS--148 patients having primary total hip replacement. INTERVENTION--Warfarin 1 mg given daily for one week before and three weeks after surgery. MAIN OUTCOME MEASURE--Deep vein thrombosis diagnosed by the iodine-125 labelled fibrinogen uptake method. RESULTS--Deep vein thrombosis occurred in 25 (34%) of the patients given warfarin and 19 (26%) of the controls (difference 8%; 95% confidence interval -6.8% to 22.8%). CONCLUSION--Fixed minidose warfarin does not prevent deep vein thrombosis after total hip replacement.

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Selected References

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  1. Aitken R. J., Mills C., Immelman E. J. The postphlebitic syndrome following shaft fractures of the leg. A significant late complication. J Bone Joint Surg Br. 1987 Nov;69(5):775–778. doi: 10.1302/0301-620X.69B5.3680341. [DOI] [PubMed] [Google Scholar]
  2. Brenkel I. J., Clancy M. J. Total hip replacement and antithrombotic prophylaxis. Br J Hosp Med. 1989 Oct;42(4):282–284. [PubMed] [Google Scholar]
  3. 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]
  4. Hampson W. G., Harris F. C., Lucas H. K., Roberts P. H., McCall I. W., Jackson P. C., Powell N. L., Staddon G. E. Failure of low-dose heparin to prevent deep-vein thrombosis after hip-replacement arthroplasty. Lancet. 1974 Oct 5;2(7884):795–797. doi: 10.1016/s0140-6736(74)91068-x. [DOI] [PubMed] [Google Scholar]
  5. Harris W. H., McKusick K., Athanasoulis C. A., Waltman A. C., Strauss H. W. Detection of pulmonary emboli after total hip replacement using serial C15O2 pulmonary scans. J Bone Joint Surg Am. 1984 Dec;66(9):1388–1393. [PubMed] [Google Scholar]
  6. Harris W. H., Salzman E. W., Athanasoulis C., Waltman A. C., Baum S., DeSanctis R. W. Comparison of warfarin, low-molecular-weight dextran, aspirin, and subcutaneous heparin in prevention of venous thromboembolism following total hip replacement. J Bone Joint Surg Am. 1974 Dec;56(8):1552–1562. [PubMed] [Google Scholar]
  7. Johnson R., Green J. R., Charnley J. Pulmonary embolism and its prophylaxis following the Charnley total hip replacement. Clin Orthop Relat Res. 1977;(127):123–132. [PubMed] [Google Scholar]
  8. Kakkar V. V., Nicolaides A. N., Renney J. T., Friend J. R., Clarke M. B. 125-I-labelled fibrinogen test adapted for routine screening for deep-vein thrombosis. Lancet. 1970 Mar 14;1(7646):540–542. doi: 10.1016/s0140-6736(70)90769-5. [DOI] [PubMed] [Google Scholar]
  9. Magnussen P. A., Crozier A. E., Gregg P. J. Detecting haematomas by ultrasound: brief report. J Bone Joint Surg Br. 1988 Jan;70(1):150–150. doi: 10.1302/0301-620X.70B1.3276701. [DOI] [PubMed] [Google Scholar]
  10. Morris G. K., Henry A. P., Preston B. J. Prevention of deep-vein thrombosis by low-dose heparin in patients undergoing total hip replacement. Lancet. 1974 Oct 5;2(7884):797–800. doi: 10.1016/s0140-6736(74)91069-1. [DOI] [PubMed] [Google Scholar]
  11. Poller L., McKernan A., Thomson J. M., Elstein M., Hirsch P. J., Jones J. B. Fixed minidose warfarin: a new approach to prophylaxis against venous thrombosis after major surgery. Br Med J (Clin Res Ed) 1987 Nov 21;295(6609):1309–1312. doi: 10.1136/bmj.295.6609.1309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. 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]

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