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Clinical Efficacy of Mechanical Thromboprophylaxis Without Anticoagulant Drugs for Elective Hip Surgery in an Asian Population
Authors:Nobuhiko Sugano  Hidenobu Miki  Nobuo Nakamura  Masaharu Aihara  Kengo Yamamoto  Kenji Ohzono
Institution:? Department of Orthopedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Orthopedic Surgery, Osaka Medical Center, Osaka, Japan; Center of Arthroplasty, Kyowakai Hospital, Suita, Japan;§ Department of Orthopedic Surgery, Kansairousai Hospital, Amagasaki, Japan; Department of Orthopedic Surgery, Hoshigaoka Koseinenkin Hospital, Hirakata, Japan
Abstract:To evaluate the clinical efficacy of mechanical thromboprophylaxis after elective hip surgery, we reviewed 3016 patients who underwent hip surgery at 5 centers. Primary total hip arthroplasty (THA), revision THA, and pelvic or femoral osteotomies were performed in 2648, 298, and 70 patients, respectively. Epidural anesthesia, intraoperative calf bandage, early mobilization, and intermittent pneumatic compression postoperatively with additional use of elastic stockings were the basic regimen for thromboprophylaxis. Postoperatively, no cases of fatal pulmonary embolism (PE) were encountered. One symptomatic PE and 4 symptomatic deep vein thrombosis cases were identified, all of which were successfully treated using heparin and warfarin. By 6 months, no deaths had occurred. We conclude that mechanical thromboprophylaxis without anticoagulant drugs is safe and effective for elective hip surgeries in our patient population.
Keywords:venous thromboembolism  elective hip surgery  total hip arthroplasty  revision  osteotomy  intermittent pneumatic compression
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