Thromboprophylaxis after replacement arthroplasty

doi:10.1136/bmj.322.7288.686

BMJ 2001;322:686-687 ( 24 March )

Editorials

Thromboprophylaxis after replacement arthroplasty

Anticoagulants are more effective than aspirin

The first 150 words of the full text of this article appear below.

Venous thromboembolism remains the greatest single threat to life during the extended postoperative period after total hiparthroplasty.¹ Several prophylactic measures are currentlyused, including elastic stockings and intermittent pneumatic compressionto reduce stasis, and aspirin or various forms of anticoagulationto counteractact hypercoagulability. Evidence for the effectivenessof these different forms of prophylaxis varies from large multicentretrials in thousands of patients to small single centre studies,and there is no clear consensus on the best form ofprophylaxis.

Thrombosis is less likely if venous stasis is minimised, and this is the rationale for the use of elastic support stockingsand raising the foot of the bed. These passive measures have beenused for years, and, though they help prevent venous thromboembolism,they are not sufficiently effective on their own after major jointreplacement. Nevertheless, intermittent pneumatic compressionof the legs in 500 patients undergoing hip replacement reducedthe overall . . . [Full text of this article]

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Relevant Article

Thromboprophylaxis after replacement arthroplasty: David A Macdonald and Duncan P Thomas
BMJ 2001 322: 1546. [Extract] [Full Text]

This article has been cited by other articles:

Howie, C., Hughes, H., Watts, A. C., Scottish Arthoplasty Project, (2005). Venous thromboembolism associated with hip and knee replacement over a ten-year period: A POPULATION-BASED STUDY. J Bone Joint Surg Br 87-B: 1675-1680 [Abstract] [Full text]
Macdonald, D. A, Thomas, D. P (2001). Thromboprophylaxis after replacement arthroplasty. BMJ 322: 1546-1546 [Full text]

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