Why the study?
Does prophylactic anticoagulation starting 4 days before operation reduce the incidence of proximal localized deep venous thrombosis in patients undergoing total hip replacement compared to starting on the eve of the operation?
Does prophylactic anticoagulation starting 4 days before operation reduce the incidence of proximal localized deep venous thrombosis in patients undergoing total hip replacement compared to starting on the eve of the operation?
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Starting prophylactic anticoagulation 4 days before total hip replacement does not reduce the incidence of proximal deep venous thrombosis compared to starting on the eve of the operation.
A prospective randomized study involving 101 patients undergoing total hip replacement was performed to find out whether prophylactic anticoagulation starting 4 days before the operation was more effective than starting on the eve of the operation. The postoperative level of anticoagulation was set at an INR of 2.1. There was no difference between the two groups in the incidence of proximal localized deep venous thrombosis. Blood loss did not depend on the level of peroperative anticoagulation. There were no postoperative hemorrhagic complications. No fatal pulmonary embolism occurred during the study. After discontinuation of the oral anticoagulants because of a negative venogram, nonfatal pulmonary embolism occurred in 3 out of 55 patients. A plea is made for low-dose anticoagulation for 3 months after total hip arthroplasty.
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Swierstra et al. (1988) studied this question.
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