ADAPTED LOW-DOSE ORAL ANTICOAGULANTS FOLL OWING FETAL HIP-REPLACEMENT

This study reports the efficacy in the prevention of thromboembolic co mplications of adapted low-dose oral anticoagulants following total hi p replacement. 750 patients undergoing total hip replacement received oral anticoagulants as exclusive drug prophylaxis for thromboembolic c omplications. These patients were considered preoperatively not to pre sent any particular risk for the development of postoperative thrombos is. Anticoagulant therapy was commenced on the evening of the operatio n. Eleven pulmonary embolisms (1.5 per cent) were observed, but none o f them were fatal. The risk of thrombosis was evaluated in 100 of thes e 750 patients by means of bilateral venography of the lower limbs: 21 patients developed distal thrombosis (sural veins) and 2 patients dev eloped proximal femoral thrombosis. Only one haemorrhagic complication occurred in the 750 patients of this series. The prothrombin profile determined in the patients developing thrombosis or pulmonary embolism was not significantly different from that of the patients free of any thromboembolic complications. Although oral anticoagulants appear to be particularly effective for the prevention of fatal pulmonary emboli sm, it is not clear that their efficacy is directly related to the pro thrombin time.