A review of the evidence for and against thromboprophylaxis in total hip replacement

Deep vein thrombosis (DVT) after an unprotected total hip replacement (THR) is common and this review explores the balance between risks and benefits of thrombo-prophylaxis in protecting patients undergoing THR. A literature search for English publications was conducted on Medline & PubMed. Governance bodies and their guidelines were consulted. MESH terms included Deep Vein Thrombosis OR DVT AND Prophylaxis AND Hip AND/OR Surgery AND/OR Total Replacement OR Arthroplasty. THR results in significant risk of thrombo-embolic complications with studies showing that as many as one half of patients suffer from DVT post-operatively. Prophylactic treatments are used to reduce the incidence of DVT. However, there are also risks associated with the use of prophylaxis, including excessive bleeding and major cardio-vascular events. Further investigation is required to determine which patients should be given what prophylaxis and for how long post THR.