title: Symptomatic thromboembolism after one-stage bilateral THA with a multimodal prophylaxis protocol.
abstract: To determine the incidence of thromboembolism after one-stage bilateral total hip arthroplasty and the role of two different chemoprophylaxis agents, we retrospectively studied 644 consecutive patients who underwent one-stage bilateral total hip arthroplasties. All patients received a similar multimodal prophylaxis protocol, which differed only in the postoperative chemoprophylaxis: 292 patients received warfarin (Group 1) and 352 received aspirin (Group 2). All patients were followed for a minimum of 3 months. We observed no difference in the incidence of symptomatic venous thrombosis, pulmonary embolism, or mortality in the two groups. Twenty patients in each group had deep venous thrombosis (7% and 5.7%, respectively) develop. Seven patients (2.39%) in Group 1 and eight (2.27%) in Group 2 had proximal deep venous thrombosis. Four patients in each group had a nonfatal pulmonary embolism (1.36% and 1.13%, respectively). There were two deaths in each group, neither related to venous thromboembolism. One-stage bilateral total hip arthroplasties were associated with a low rate of venous thrombosis and embolism with our multimodal prophylaxis protocol, and we found no difference in the incidence of either in patients who received warfarin or aspirin for chemoprophylaxis.
authors.affiliation: Hospital for Special Surgery and Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USA.
authors.forename: Burak
authors.initials: B
authors.lastname: Beksaç
authors.forename: Alejandro
authors.initials: A
authors.lastname: González Della Valle
authors.forename: John
authors.initials: J
authors.lastname: Anderson
authors.forename: Nigel E
authors.initials: NE
authors.lastname: Sharrock
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Salvato
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D011300:Preoperative Care; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D015996:Survival Rate; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D001241:Aspirin