Thromboprophylaxis after replacement arthroplasty

doi:10.1136/bmj.322.7301.1546/a

BMJ 2001;322:1546 ( 23 June )

Letters

Thromboprophylaxis after replacement arthroplasty

Many surgeons prefer not to prescribe chemoprophylaxis after arthroplasty

Author's reply

Many surgeons prefer not to prescribe chemoprophylaxis after arthroplasty

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

EDITOR $---$ Thomas confirms that intermittent calf compression reduces the rate of pulmonary embolism to 1% after replacement arthroplastywithout having the possible side effects of chemoprophylaxis.¹He goes on to state that when the efficacy of foot pumps was comparedwith that of anticoagulation "the results in terms of preventingdeep venous thrombosis werecomparable."

The rest of the editorial is aimed at supporting the use of anticoagulation in these patients. I presume that Thomas is neitheran orthopaedic surgeon nor a patient who has had a failed jointreplacement; if he was he would not regard an incidence of majorbleeding with anticoagulation of 1% as being an "acceptable pricetopay."

His conclusion that anticoagulation is the single most effective way of preventing these complications is not supported bythe rest of his editorial. It seems incongruous that he is suggestingusing a method of prophylaxis with . . . [Full text of this article]