Prevention and treatment of venous thromboembolic disease complications in primary hip arthroplasty patients.
This chapter is a brief and incomplete overview of a rapidly changing field. The following points are helpful for the management of hip arthroplasty patients. There is no clinically significant difference between warfarin and enoxaparin prophylaxis in terms of efficacy (venographic or clinical events) and safety. Hip arthroplasty patients should receive warfarin or enoxaparin for at least 7 to 10 days postoperatively. There is a high rate of postdischarge venographic DVT even if prophylaxis is used for 7 to 10 days after surgery. There is a 2% rate of postdischarge symptomatic DVT if prophylaxis is used for 7 to 10 days after surgery. There is a 0.1% rate of postdischarge fatal PE at 90 days postoperatively if prophylaxis is used for 7 to 10 days after surgery. The value of routine predischarge surveillance for DVT is not clear at this moment.
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University of California at San Francisco, California, USA.
D019644:Arthroplasty, Replacement, Hip; D018890:Chemoprevention; D006801:Humans; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy