Prophylaxis of deep-vein thrombosis in total hip surgery

Thromboembolism is a common and serious complication of total hip replacement. Methods of prophylaxis include combinations of physical compression of the legs and anticoagulation. Results of treatment are difficult to document and quantitate. The authors reviewed 122 patients who underwent hip arthroplasty with intermittent pneumatic calf compression, intravenous administration of dextran and platelet inhibitors. In 20% of them, clinically suspected pulmonary embolism was confirmed by ventilation perfusion lung scanning. The true incidence of pulmonary embolism is probably greater than this and it appears that the prophylactic regimen used in this study does not confer any benefit.