Skip to main content
Log in

The pathogenesis and prevention of thromboembolic complications in patients undergoing total hip replacement

  • Clinical Reviews
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Harris WH, Sledge CB. Total hip and total knee replacement. N Engl J Med 1990;323:725–31.

    Article  PubMed  CAS  Google Scholar 

  2. Johnson R, Green JR, Charnley J. Pulmonary embolism and its prophylaxis following the Charnley total hip replacement. Clin Orthop. 1977;127:123–32.

    PubMed  Google Scholar 

  3. Coon WW. Risk factors in pulmonary embolism. Surg Gynecol Obstet. 1976;143:385–90.

    PubMed  CAS  Google Scholar 

  4. Prevention of venous thrombosis and pulmonary embolism: consensus conference. JAMA 1986;256:744–9.

  5. Russell JC. Prophylaxis of postoperative deep vein thrombosis and pulmonary embolism. Surg Gynecol Obstet. 1983;157:89–104.

    PubMed  CAS  Google Scholar 

  6. Kakkar VV, Corrigan TP, Fossard DP. Prevention of fatal postoperative pulmonary embolism by low doses of heparin: an international multicentre trial. Lancet. 1975;2:45–51.

    Google Scholar 

  7. Clark C, Cotton LT. Blood flow in deep veins of the leg. Recording technique and evaluation of methods to increase flow during operation. Br J Surg. 1968;55:211–4.

    Article  PubMed  CAS  Google Scholar 

  8. Knight MTN, Dawson R. Effect of intermittent compression of the arms on deep venous thrombosis in the legs. Lancet. 1976;2:1265–7.

    Article  PubMed  CAS  Google Scholar 

  9. Gitel SN, Salvati EA, Wessler S, Robinson HJ, Worth MH. The effect of total hip replacement and general surgery on antithrombin III in relation to venous thrombosis. J Bone Joint Surg. 1979;61A:653–6.

    Google Scholar 

  10. McKenna R, Galante J, Bachman F, Wallace DL, Kaushal SP, Meredith P. Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression. BMJ. 1980;280:514–7.

    PubMed  CAS  Google Scholar 

  11. Scholz PM, Kinney JM, Chien S. Effects of major abdominal operations on human blood rheology. Surgery. 1975;77:351–9.

    PubMed  CAS  Google Scholar 

  12. Dodds AJ, Matthews PN, Bailey MJ, Flute PT, Dormandy JA. Changes in red cell deformability following surgery. Thromb Res. 1980;18:561–5.

    Article  PubMed  CAS  Google Scholar 

  13. Sikorski JM, Hampson WG, Staddon GE. The natural history and aetiology of deep vein thrombosis after total hip replacement. J Bone Joint Surg. 1981;63B:171–7.

    Google Scholar 

  14. Hampson WGJ, Lucas HK, Harris FC, Roberts PH. Failure of low-dose heparin to prevent deep-vein thrombosis after total hip arthroplasty. Lancet. 1974;2:795–7.

    Article  PubMed  CAS  Google Scholar 

  15. Bergentz SE. Incidence of thromboembolism in association with surgical and medical diseases. Acta Chir Scand Suppl. 1988;543:10–4.

    PubMed  CAS  Google Scholar 

  16. Muller R, Musikic P. Hemorheology in surgery—a review. Angiology. 1987;38:581–92.

    PubMed  CAS  Google Scholar 

  17. Stamatakis JD, Kakkar VV, Lawrence D, Bentley PG, Nairn D, Ward V. Failure of aspirin to prevent postoperative deep vein thrombosis in patients undergoing total hip replacement. BMJ. 1978;1:1031.

    PubMed  CAS  Google Scholar 

  18. Effect of aspirin on postoperative venous thrombosis. Report of the Steering Committee of a trial sponsored by the Medical Research Council. Lancet. 1972;2:441–5.

    Google Scholar 

  19. Harris WH, Athanasoulis CA, Waltman AC, Salzman EW. Prophylaxis of deep-vein thrombosis after total hip replacement. Dextran and external pneumatic compression compared with 1.2 or 0.3 gram of aspirin daily. J Bone Joint Surg. 1985;67A:57–62.

    Google Scholar 

  20. Collins R, Scrimgeour A, Yusuf S, Peto R. Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. Overview of results of randomized trials in general, orthopedic and urologic surgery. N Engl J Med. 1988;318:1162–72.

    Article  PubMed  CAS  Google Scholar 

  21. Williams JW, Eikman EA, Greenberg SH, et al. Failure of low dose heparin to prevent pulmonary embolism after hip surgery or above the knee amputation. Ann Surg. 1978;188:468–74.

    Article  PubMed  CAS  Google Scholar 

  22. Harris WH, Salzman EW, Athanasoulis C, Waltman AC, Baum S, DeSanctis RW. Comparison of warfarin, low-molecular-weight dextran, aspirin, and subcutaneous heparin in prevention of venous thromboembolism following total hip replacement. J Bone Joint Surg. 1974;56A:1552–62.

    Google Scholar 

  23. Evarts CM, Alfidi RJ. Thromboembolism after total hip reconstruction. Failure of low doses of heparin in prevention. JAMA. 1973;225:515–6.

    Article  PubMed  CAS  Google Scholar 

  24. Evarts CM, Feil EJ. Prevention of thromboembolic disease after elective surgery of the hip. J Bone Joint Surg. 1971;53A:1271–80.

    Google Scholar 

  25. Leyvraz PF, Richard J, Bachmann F, et al. Adjusted versus fixed-dose subcutaneous heparin in the prevention of deep-vein thrombosis after total hip replacement. N Engl J Med. 1983;309:954–8.

    Article  PubMed  CAS  Google Scholar 

  26. Fernandez F, N’Guyen P, Van Ryn J, Ofosu FA, Hirsh J, Buchanan MR. Hemorrhagic doses of heparin and other glycosaminoglycans induce a platelet defect. Thromb Res. 1986;43:491–5.

    Article  PubMed  CAS  Google Scholar 

  27. Salzman EW. Low-molecular-weight heparin: is small beautiful? N Engl J Med. 1986;315:957–9.

    Article  PubMed  CAS  Google Scholar 

  28. Carter CJ, Kelton JG, Hirsh J, Cerskus A, Santos AV, Gent M. The relationship between the hemorrhagic and antithrombotic properties of low molecular weight heparin in rabbits. Blood. 1982;59:1239–45.

    PubMed  CAS  Google Scholar 

  29. Ockelford PA, Carter CJ, Cerskus A, Smith CA, Hirsh J. Comparison of the in vivo hemorrhagic and antithrombotic effects of a low antithrombin III affinity heparin fraction. Thromb Res. 1982;27:679–90.

    Article  PubMed  CAS  Google Scholar 

  30. Kakkar VV, Murray WJG. Efficacy and safety of low-molecular-weight heparin (CY216) in preventing postoperative venous thromboembolism: a co-operative study. Br J Surg. 1985;72:786–91.

    Article  PubMed  CAS  Google Scholar 

  31. Turpie AGG, Levine MN, Hirsh J, et al. A randomized controlled trial of a low-molecular-weight heparin (Enoxaparin) to prevent deep-vein thrombosis in patients undergoing elective hip surgery. N Engl J Med. 1986;315:925–9.

    Article  PubMed  CAS  Google Scholar 

  32. Planes A, Vochelle N, Mazas F, et al. Prevention of postoperative venous thrombosis: a randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement. Thromb Haemost. 1988;60:407–10.

    PubMed  CAS  Google Scholar 

  33. Levine MN, Hirsh J, Gent M, et al. Prevention of deep vein thrombosis after elective hip surgery. A randomized trial comparing low molecular weight heparin with standard unfractionated heparin. Ann Intern Med. 1991;114:545–51.

    PubMed  CAS  Google Scholar 

  34. Collins GJ, Bergentz SE. Dextrans. In: Collins GJ (ed). Vascular occlusive disorders. Medical and surgical management. Mount Kisco, NY: Futura Publishing Company, 1981;393–419.

    Google Scholar 

  35. Ljungstrom KG. The antithrombotic efficacy of dextran. Acta Chir Scand Suppl. 1988;543:26–30.

    PubMed  CAS  Google Scholar 

  36. Bergqvist D. Prevention of postoperative thromboembolism in Sweden—the development of practice during five years. Thromb Haemost. 1985;53:239–41.

    PubMed  CAS  Google Scholar 

  37. Barber HM, Galasko CSB, Sutton RA, et al. A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement. Postgrad Med J. 1977;53:130–3.

    PubMed  CAS  Google Scholar 

  38. Bergqvist D, Efsing HO, Hallbook T, Hedlund T. Thromboembolism after elective and post-traumatic hip surgery—a controlled prophylactic trial with dextra 70 and low-dose heparin. Acta Chir Scand. 1979;145:213–8.

    PubMed  CAS  Google Scholar 

  39. Neu LT, Waterfield JR, Ash CJ. Prophylactic anticoagulant therapy in the orthopedic patient. Ann Intern Med. 1965;62:463–7.

    PubMed  CAS  Google Scholar 

  40. Harris WH, Salzman EW, DeSanctis RW. The prevention of thromboembolic disease by prophylactic anticoagulation. A controlled study in elective hip surgery. J Bone Joint Surg. 1967;49A:81–9.

    Google Scholar 

  41. Coventry MB, Nolan DR, Beckenbaugh RD. “Delayed” prophylactic anticoagulation: a study of results and complications in 2,012 total hip arthroplasties. J Bone Joint Surg. 1973;55-A:1487–92.

    Google Scholar 

  42. Bergqvist D. Oral anticoagulants for prophylaxis against postoperative thromboembolism. Acta Chir Scand Suppl. 1988;543:43–7.

    PubMed  CAS  Google Scholar 

  43. Francis CW, Marder VJ, Evarts CM, Yaukoolbodi S. Two-step warfarin therapy. Prevention of postoperative venous thrombosis without excessive bleeding. JAMA. 1983;249:374–8.

    Article  PubMed  CAS  Google Scholar 

  44. Hull R, Hirsh J, Jay R, et al. Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med. 1982;307:1676–81.

    Article  PubMed  CAS  Google Scholar 

  45. Paiement G, Wessinger SJ, Waltman AC, Harris WH. Low-dose warfarin versus external pneumatic compression for prophylaxis against venous thromboembolism following total hip replacement. J Arthroplasty. 1987;2:23–6.

    Article  PubMed  CAS  Google Scholar 

  46. Amstutz HC, Friscia DA, Dorey F, Carney BT. Warfarin prophylaxis to prevent mortality from pulmonary embolism after total hip replacement. J Bone Joint Surg. 1989;71A:321–6.

    Google Scholar 

  47. Dale C, Gallus A, Wycherley A, Langlois S, Howie D. Prevention of venous thrombosis with minidose warfarin after joint replacement. BMJ. 1991;303:224.

    PubMed  CAS  Google Scholar 

  48. Fordyce MJF, Baker AS, Staddon GE. Efficacy of fixed minidose warfarin prophylaxis in total hip replacement. BMJ. 1991;303:219–20.

    Article  PubMed  CAS  Google Scholar 

  49. Muhe E. Intermittent sequential high-pressure compression of the leg. A new method of preventing deep vein thrombosis. Am J Surg. 1984;147:781–5.

    Article  PubMed  CAS  Google Scholar 

  50. Blackshear WM, Prescott C, LePain F, Benoit S, Dickstein R, Seifert KB. Influence of sequential pneumatic compression on postoperative venous function. J Vasc Surg. 1987;5:432–6.

    Article  PubMed  Google Scholar 

  51. Guyton DP, Khayat A, Husni EA, Schreiber H. Elevated levels of 6-keto-prostaglandin-F1A from a lower extremity during external pneumatic compression. Surg Gynecol Obstet. 1988;166:338–42.

    PubMed  CAS  Google Scholar 

  52. Tarnay TJ, Rohr PR, Davidson AG, Stevenson MM, Byars EF, Hopkins GR. Pneumatic calf compression, fibrinolysis, and the prevention of deep venous thrombosis. Surgery. 1980;88:489–96.

    PubMed  CAS  Google Scholar 

  53. Caprini JA, Chucker JL, Zuckerman L, Vagher JP, Franck CA, Cullen JE. Thrombosis prophylaxis using external compression. Surg Gynecol Obstet. 1983;156:599–604.

    PubMed  CAS  Google Scholar 

  54. Nicolaides AN, Miles C, Hoare M, Jury P, Helmis E, Venniker R. Intermittent sequential pneumatic compression of the legs and thromboembolism-deterrent stockings in the prevention of postoperative deep venous thrombosis. Surgery. 1983;94:21–5.

    PubMed  CAS  Google Scholar 

  55. Nicolaides AN, Fernandes JF, Pollock AV. Intermittent sequential pneumatic compression of the legs in prevention of venous stasis and postoperative deep venous thrombosis. Surgery. 1980;87:69–76.

    PubMed  CAS  Google Scholar 

  56. Salzman EW. Physical methods for prevention of venous thromboembolism. Surgery. 1977;81:123–4.

    PubMed  CAS  Google Scholar 

  57. Hartman JT, Pugh JL, Smith RD, Robertson WW, Yost RP, Janssen HF. Cyclic sequential compression of the lower limb in prevention of deep venous thrombosis. J Bone Joint Surg. 1982;64A:1059–62.

    Google Scholar 

  58. Hull RD, Raskob GE, Gent M, et al. Effectiveness of intermittent pneumatic leg compression for preventing deep vein thrombosis after total hip replacement. JAMA. 1990;263:2313–7.

    Article  PubMed  CAS  Google Scholar 

  59. Harris WH, Raines J, Athanasoulis C, Waltman AC, Salzman EW. External pneumatic compression versus warfarin in reducing thrombosis in high-risk hip patients. In: Madden JL, Hume M (eds). Venous thromboembolism: prevention and treatment. New York: Appleton-Century-Crofts, 1976;51–60.

    Google Scholar 

  60. Harris WH. (Letter). J Bone Joint Surg. 1985;67A:983.

    Google Scholar 

  61. Landefeld CS, McGuire E, Cohen AM. Clinical findings associated with acute proximal deep vein thrombosis: a basis for quantifying clinical judgement. Am J Med. 1990;88:382–8.

    Article  PubMed  CAS  Google Scholar 

  62. Hirsh J, Hull RD, Raskob GE. Clinical features and diagnosis of venous thrombosis. J Am Coll Cardiol. 1986;8:114B-27B.

    Article  PubMed  CAS  Google Scholar 

  63. Hoellerich VL, Wigton RS. Diagnosing pulmonary embolism using clinical findings. Arch Intern Med. 1986;146:1699–704.

    Article  PubMed  CAS  Google Scholar 

  64. Hull R, Hirsh J, Sackett DL, et al. Replacement of venography in suspected venous thrombosis by impedance plethysmography and 125I-fibrinogen leg scanning: a less invasive approach. Ann Intern Med. 1981;94:12–5.

    PubMed  CAS  Google Scholar 

  65. Paiement G, Wessinger SJ, Waltman AC, Harris WH. Surveillance of deep vein thrombosis in asymptomatic total hip replacement patients. Impedance phlebography and fibrinogen scanning versus roentgenographic phlebography. Am J Surg. 1988;155:400–4.

    Article  PubMed  CAS  Google Scholar 

  66. Cruickshank MK, Levine MN, Hirsh J, et al. An evaluation of impedance plethysmography and 125I-fibrinogen leg scanning in patients following hip surgery. Thromb Haemost. 1989;62:830–4.

    PubMed  CAS  Google Scholar 

  67. Harris WH, McKusick K, Athanasoulis CA, Waltman AC, Strauss HW. Detection of pulmonary embolis after total hip replacement using serial C1502 pulmonary scans. J Bone Joint Surg. 1984;66A:1388–93.

    Google Scholar 

  68. Bell WR, Simon TL. Current status of pulmonary thromboembolic disease: pathophysiology, diagnosis, prevention, and treatment. Am Heart J. 1982;103:239–62.

    Article  PubMed  CAS  Google Scholar 

  69. Hull RD, Hirsh J, Sackett DL, Stoddart GL. Cost—effectiveness of primary and secondary prevention of fatal pulmonary embolism in high-risk surgical patients. Can Med Assoc J. 1982;127:990–5.

    PubMed  CAS  Google Scholar 

  70. Oster G, Tuden RL, Colditz GA. A cost—effectiveness analysis of prophylaxis against deep-vein thrombosis in major orthopedic surgery. JAMA. 1987;257:203–8.

    Article  PubMed  CAS  Google Scholar 

  71. Paiement GD, Wessinger SJ, Harris WH. Survey of prophylaxis against venous thromboembolism in adults undergoing hip surgery. Clin Orthop. 1987;223:188–93.

    PubMed  Google Scholar 

  72. Francis CW, Pellegrini VD, Marder VJ, et al. Comparison of warfarin and external pneumatic compression in prevention of venous thrombosis after total hip replacement. JAMA. 1992;267:2911–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Potyk, D.K., Tabbarah, H.J. The pathogenesis and prevention of thromboembolic complications in patients undergoing total hip replacement. J Gen Intern Med 8, 213–219 (1993). https://doi.org/10.1007/BF02599270

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02599270

Keywords

Navigation