Lower risk of thromboembolic disease after total hip replacement with non-cemented than with cemented prostheses

During the course of a prospective, randomised trial comparing dextran 40 with antithrombin III plus heparin as prophylaxis against thrombosis after total hip replacement, an unexpectedly low incidence of postoperative thromboembolic disease was found in patients receiving non-cemented (0 of 23) rather than cemented prostheses (4 of 13, 31%). Despite the small number of patients, the difference was significant and necessitated modification of the protocol. These preliminary findings suggest that the type of hip replacement used was more important than the type of antithrombotic medication in preventing venous thrombosis and pulmonary embolism.