Thromboprophylaxis by low-molecular-weight heparin in elective hip surgery. A placebo controlled study.
In a double-blind, randomised study of thromboprophylaxis in patients undergoing total hip replacement, we compared a low-molecular-weight heparin with a placebo. Of the 120 patients enrolled, 112 completed the trial; 58 in the treatment group and 54 in the placebo group. Nine (16%) patients in the treatment group and 19 (35%) in the placebo group developed deep venous thrombosis, diagnosed by the 125I-fibrinogen uptake test (p < 0.02). Verification was obtained by phlebography in 86% of the patients. Prolonged surgery increased the risk of thrombosis in the placebo group but not in the treatment group (p < 0.05). There were significantly more cases of deep venous thrombosis in the placebo group during the first four postoperative days (p < 0.02). The groups did not differ with respect to peroperative and postoperative bleeding. Low-molecular-weight heparin offers safe and easily administered thromboprophylaxis in total hip replacement.
Tørholm
C
C
Department of Orthopaedics, University Hospital, Copenhagen, Denmark.
Broeng
L
L
Jørgensen
P S
PS
Bjerregaard
P
P
Josephsen
L
L
Jørgensen
P K
PK
Hagen
K
K
Knudsen
J B
JB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017985:Dalteparin / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005340:Fibrinogen; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007279:Injections, Subcutaneous; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013924:Thrombophlebitis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D007457:Iodine Radioisotopes; D005340:Fibrinogen; D017985:Dalteparin