Thromboembolic complications after total hip arthroplasty and prevention of thrombosis: own experience

Background. Total hip arthroplasty (THA) is today one of the most frequently performed major surgical operations in orthopedics. Although it is the standard method of treatment for advanced degenerative changes in the joint, the operation is accompanied by a high risk of thromboembolic complications. Material and methods. The present study is a retrospective analysis of two groups of THA patients. Group I consisted of 80 patients (average age 62) operated 1980-1983, for whom no prophylaxis was applied. In Group II, low molecular weight heparin (LMWH) was applied pre- and postoperatively. This group consisted of 94 patients (average age 63.5) operated in the year 1998. Thromboembolic complications were diagnosed on the basis of reported symptoms, physical examinations and additional tests (chest x-ray, EKG, gasometry). Results. In Group I there were 11 complications (13.75%), including 10 cases (91%) of deep venous thromboembolic disease of the lower extremities (DVT) and 1 case (9%) of pulmonary embolism (PE), while in Group II there were only 2 complications (2.1%), 1 DVT and 1 PE. The difference between groups was statistically significant. The risk factors for venous thromboembolic disease were analyzed. In both study groups, the predominant risk factors were prolonged duration of surgery and diabetes accompanied by venous insufficiency. Conclusions. The results of our analysis showed that the use of DVT prophylaxis with low-molecular heparin in the preoperative and postoperative period reduced the occurrence of thromboembolic complications.