[An effective method to prevent deep venous thrombosis in total hip arthroplasty: a study in patients with and without risk factors for thrombotic disease].
OBJECTIVE
The aim of this study was to determine a safe and effective method of prophylaxis for thromboembolis diseases after THA.


METHODS
This study was conducted on 157 patients consecutively admitted to our Department of Orthopedics to undergo elective THA from October 2000 o May 2001. We have preoperatively investigated plasma levels of homocysteine, AT III activity, Fibrinogen levels, Anticardiolipin antibodies, and circulating vWFag D-dimer levels were measured by Asserachrom D-dimer ELISA preoperatively and on day 4 postoperatively. Thromboprophylactic regimen was based on a prolonged subcutaneous administration of nadroparin (for 40 days after surgery) and was used in all patients, with a dose based on body weight. Compression ultrasonography was udes as screening test for the diagnosis of deep venous thrombosis and performed in each patient on postoperative day 4, 15, and 30.


RESULTS
Although all patients enrolled in this study showed increased risk for thrombotic disease, none oh them developed either symptomatic or asymptomatic deep venous thrombosis. No complications were observed, including major bleeding or abnormalities of laboratory tests.


CONCLUSIONS
Our study indicates that prolonged thromboprophylaxis with nadroparin for 40 days postoperatively, associated with early mobilization, is an effective and safe protocol of antithrombotic prophylaxis in patients operated for THA with and without risk factors for thrombotic disease.
Pola
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Dipartimento di Ortopedia, Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italia. ppola@rm.unicatt.it
Papaleo
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Cerciello
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Aulisa
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Mazza
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Aulisa
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D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D003627:Data Interpretation, Statistical; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D017762:Nadroparin / Q000008:administration & dosage / Q000627:therapeutic use*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D017762:Nadroparin