Unfractionated heparin and mechanical thromboprophylaxis in hip arthroplasty.
OBJECTIVE
To evaluate the efficacy and safety of unfractionated heparin associated with mechanical prophylaxis as a method for preventing venous thromboembolism in hip arthroplasty.


METHODS
We retrospectively reviewed the records of 181 hip arthroplasties out of 216 consecutive cases performed over a period of 39 months in our hospital. We excluded 35 cases due to non-adherence to the standardized method of thromboprophylaxis or loss to follow-up. All arthroplasties evaluated completed one-year follow-up after surgery with five consultations at predefined periods. Efficacy of the proposed method was evaluated by the occurrence of symptomatic venous thromboembolism confirmed by specific tests and safety was determined by the lack of occurrence of major bleeding according to criteria established by the International Society on Thrombosis and Haemostasis.


RESULTS
There were four cases of symptomatic venous thromboembolism (2.2%), with three cases of deep vein thrombosis (1.65%) and one case of pulmonary embolism (0.55%). We found one case of severe bleeding (0.55%).


CONCLUSIONS
Unfractionated heparin associated with mechanical prophylaxis proved to be an effective and safe method for preventing venous thromboembolism in patients undergoing hip arthroplasty, presenting rates of thromboembolic complications and major bleeding within the range reported with other methods currently used of thromboprophylaxis. Level of Evidence IV, Case Series.
Universidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Flávio Luís
FL
Garcia
Universidade de São Paulo (HCFMRP-USP), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Murilo Humberto Tobias
MH
Marins
Universidade de São Paulo (HCFMRP-USP), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Thiago Bortoletto
TB
Raddi
Universidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Celso Hermínio Ferraz
CH
Picado
Arthroplasty, replacement, hip; Hemorrhage; Heparin; Pulmonary embolism; Venous thrombosis