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September 1, 1989The American Journal of MedicineOpen Access

Antithrombin III prophylaxis of venous thromboembolic disease after total hip or total knee replacement

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Key result

Antithrombin III combined with low-dose heparin limits VTE to ~7% after total hip replacement.

Why the study?

Does antithrombin III combined with low-dose heparin prevent venous thromboembolic disease in patients undergoing total hip or knee replacement?

Population

Patients undergoing total hip replacement or total knee replacement

Comparison

Antithrombin III replacement in combination with… vs Dextran 40 (in the hip replacement trial)

Design

RCT, Randomized prospective

Follow-up

Postoperative

Authors

CFCharles W. FrancisVascular MedicineVPVincent D. PellegriniDartmouth CollegeCHCarl M. HarrisUnited States Army War College

Discussion

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Implication

Supports antithrombin III plus low-dose heparin for VTE prophylaxis after hip replacement; confirms benefit in postoperative orthopedic patients.

Study Design

Type

RCT

Randomization

Randomized

Structured PICO

Does antithrombin III combined with low-dose heparin prevent venous thromboembolic disease in patients undergoing total hip or knee replacement?

P
Population
Patients undergoing total hip or total knee replacement evaluated for postoperative venous thrombosis prevention.
I
Intervention
Antithrombin III (ATIII) replacement (1,500 units preoperatively and 1,000 units daily for five days, or twice this dose) in combination with low-dose heparin
C
Comparator
Dextran 40 (in the hip replacement trial)
O
Outcome
Incidence of venous thromboembolic disease (venographically controlled)hard clinical

Antithrombin III replacement combined with low-dose heparin is an effective prophylactic regimen for preventing venous thromboembolic disease following total hip replacement.

Cite This Study

Francis et al. (1989) conducted an RCT in Venous thromboembolic disease after total hip or total knee replacement. Antithrombin III (ATIII) and low-dose heparin vs. Dextran 40 was evaluated on Incidence of venous thromboembolic disease. Antithrombin III combined with low-dose heparin was an effective prophylactic regimen following total hip replacement, resulting in a 7% incidence of venous thromboembolic disease.

synapsesocial.com/papers/6aa613754dd50f8a0764be39https://doi.org/10.1016/0002-9343(89)80534-0
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prophylaxis for Postoperative Deep-Vein Thrombosis1979 · 95 citations
  2. 2Prophylaxis for postoperative deep-vein thrombosis. Synergistic effect of heparin and dihydroergotamine1979 · 120 citations
  3. 3'Delayed' Prophylactic Anticoagulation1973 · 205 citations
  4. 4Two-Step Warfarin Therapy1983 · 241 citations
  5. 5A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement1977 · 28 citations