Abstract
In a randomized, controlled clinical study, dextran-70, warfarin, or low-dose heparin were administered to patients undergoing total hip replacement on one surgical unit in an attempt to prevent deep venous thrombosis and pulmonary embolism. Calf vein thrombosis was detected by the 125I-fibrinogen uptake test. None of the methods prevented calf vein thrombosis (dextran-70, 51%; warfarin, 58-6%; heparin, 52-6%). Pulmonary embolism was completely prevented in patients treated with warfarin but occurred in 4% of patients treated with dextran-70 and 15-5% of those treated with low-dose heparin. The incidence of complications of therapy was small and comparable in each group. It is suggested that calf vein thrombosis is a frequent and in itself a non-serious complication of total hip replacement surgery and that emphasis might be placed more usefully on prevention of pulmonary embolism.
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- Atkins P., Hawkins L. A. Detection of venous thrombosis in the legs. Lancet. 1965 Dec 11;2(7424):1217–1219. doi: 10.1016/s0140-6736(65)90638-0. [DOI] [PubMed] [Google Scholar]
- Bonnar J., Walsh J. Prevention of thrombosis after pelvic surgery by British dextran 70. Lancet. 1972 Mar 18;1(7751):614–616. doi: 10.1016/s0140-6736(72)90410-2. [DOI] [PubMed] [Google Scholar]
- Brozović M., Stirling Y., Klenerman L., Lowe L. Letter: Subcutaneous heparin and postoperative thromboembolism. Lancet. 1974 Jul 13;2(7872):99–100. doi: 10.1016/s0140-6736(74)91654-7. [DOI] [PubMed] [Google Scholar]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- Mavor G. E., Walker M. G., Dhall D. P., Mahaffy R. G., Duthie J. S., Gaddie J., Reid G. F. Peripheral venous scanning with 125I-tagged fibrinogen. Lancet. 1972 Mar 25;1(7752):661–663. doi: 10.1016/s0140-6736(72)90463-1. [DOI] [PubMed] [Google Scholar]
- 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]
- Muckle D. S., Forney H. J., Bentley G. The value of prophylactic anticoagulant therapy with warfarin after hip surgery. Acta Orthop Scand. 1974;45(3):412–420. doi: 10.3109/17453677408989163. [DOI] [PubMed] [Google Scholar]
- 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]
- 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]