title: The effect of intraoperative heparin administered during total hip arthroplasty on the incidence of proximal deep vein thrombosis assessed by magnetic resonance venography.
abstract: Intraoperative, unfractionated heparin, administered intravenously before the femoral work, has demonstrated to be effective in reducing the strong thrombotic stimulus that occurs during total hip arthroplasty (THA) surgery. This randomized, double-blind, prospective study included only THA patients with significant comorbidities predisposing them to deep vein thrombosis (DVT). The 2 groups consisted of study patients who received a single dose of intravenous, intraoperative, unfractionated heparin and control patients who received a single dose of intravenous, intraoperative saline. Magnetic resonance venography was used as the DVT diagnostic tool. The overall prevalence of proximal femoral vein clots was 2.2% (3 of 134), whereas pelvic thrombosis was detected in 10.4% (14 of 134). This study demonstrated that pelvic thrombi may form following THA and that a single dose of intraoperative heparin does not prevent their formation, but may be effective at preventing ipsilateral femoral thrombi. This study strongly supports a multimodal approach to DVT prophylaxis following THA.
authors.affiliation: Department of Orthopedics, Hospital for Special Surgery, Cornell University Medical Center, New York, New York 10021, USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Salvati
authors.forename: Nigel
authors.initials: N
authors.lastname: Sharrock
authors.forename: Hollis G
authors.initials: HG
authors.lastname: Potter
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Sánchez
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011446:Prospective Studies; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006493:Heparin