title: Complications related to therapeutic anticoagulation in total hip arthroplasty.
abstract: Bleeding-related wound complications cause significant morbidity in lower limb arthroplasty surgery. Patients who require therapeutic anticoagulation in the perioperative period are potentially at higher risk for these complications. This is a retrospective case-control study reviewing all primary total hip arthroplasties performed in a single center during a 5-year period and comparing outcomes of the patients on warfarin with a double-matched control group of patients not on warfarin. The warfarin group had a significantly higher risk of deep joint infection (9% vs 2.2%), hematoma/wound ooze (28% vs 4%), and superficial infection (13.5% vs 2.2%). Managing patients undergoing total hip arthroplasty with therapeutic anticoagulation is a balance between the risk of thromboembolic disease and bleeding-related complications. Improved understanding of this risk will better allow patients to make an informed decision regarding their elective arthroplasty surgery.
authors.affiliation: The Prince Charles Hospital Orthopaedic, Research and Audit Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: McDougall
authors.forename: Hamish S
authors.initials: HS
authors.lastname: Gray
authors.forename: Philip M
authors.initials: PM
authors.lastname: Simpson
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Whitehouse
authors.forename: Ross W
authors.initials: RW
authors.lastname: Crawford
authors.forename: William J
authors.initials: WJ
authors.lastname: Donnelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D016459:Prosthesis-Related Infections; D012086:Reoperation; D013530:Surgical Wound Infection; D013923:Thromboembolism / Q000517:prevention & control*; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin