Multimodal prophylaxis for THA with mechanical compression.

Journal Article (Journal Article)

We used mechanical thromboembolism prophylaxis using intraoperative thigh-calf pneumatic compression and other measures in 1032 consecutive primary and revision total hip arthroplasties. No chemical prophylactic measures were used until after duplex ultrasonography was performed by experienced technologists before discharge. Asymptomatic proximal thrombi were treated with low molecular weight heparin and warfarin, whereas those patients with a negative scan or distal thrombi only were advised to take aspirin 325 mg twice a day for 6 weeks. Regional anesthesia was used in 95% of the arthroplasties. Using this protocol, the 30-day mortality was 0.3%. There was one autopsy-proven fatal pulmonary embolism (0.09%). One other patient died suddenly with cardiac arrest after abdominal pain and vomiting, but no autopsy was performed. Symptomatic pulmonary embolism occurred in seven patients (0.7%), four occurring early and three late. Only one of these seven patients had a positive duplex scan. Deep vein thrombosis occurred in 41 patients (3.9%) and 35 remained asymptomatic. We observed no association between type of surgery (primary or revision), age, gender or preoperative diagnosis and pulmonary embolism or deep vein thrombosis. The data confirm the efficacy of a multimodal protocol with thigh-calf mechanical prophylaxis for almost all patients undergoing primary or revision total hip arthroplasty.

Full Text

Duke Authors

Cited Authors

  • Lachiewicz, PF; Soileau, ES

Published Date

  • December 2006

Published In

Volume / Issue

  • 453 /

Start / End Page

  • 225 - 230

PubMed ID

  • 17006365

International Standard Serial Number (ISSN)

  • 0009-921X

Digital Object Identifier (DOI)

  • 10.1097/01.blo.0000238861.84733.9d

Language

  • eng

Conference Location

  • United States