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Efficacy of fixed minidose warfarin prophylaxis in total hip replacement
M J Fordyce1, A S Baker, G E Staddon
1Winford Orthopaedic Hospital, Bristol.
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.