title: A review of the evidence for and against thromboprophylaxis in total hip replacement.
abstract: Deep vein thrombosis (DVT) after an unprotected total hip replacement (THR) is common and this review explores the balance between risks and benefits of thrombo-prophylaxis in protecting patients undergoing THR. A literature search for English publications was conducted on Medline & PubMed. Governance bodies and their guidelines were consulted. MESH terms included Deep Vein Thrombosis OR DVT AND Prophylaxis AND Hip AND/OR Surgery AND/OR Total Replacement OR Arthroplasty. THR results in significant risk of thrombo-embolic complications with studies showing that as many as one half of patients suffer from DVT post-operatively. Prophylactic treatments are used to reduce the incidence of DVT. However, there are also risks associated with the use of prophylaxis, including excessive bleeding and major cardio-vascular events. Further investigation is required to determine which patients should be given what prophylaxis and for how long post THR.
authors.affiliation: Oxford University & St George's NHS Healthcare Trusts, UK. mahiben.maruthappu@gtc.ox.ac.uk
authors.forename: Mahiben
authors.initials: M
authors.lastname: Maruthappu
authors.forename: Myura
authors.initials: M
authors.lastname: Nagendran
authors.forename: Kapil
authors.initials: K
authors.lastname: Sugand
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Bulstrode
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants