A shortened course of anticoagulation to treat deep venous thrombosis after total joint arthroplasty

Objective: To study whether the course of anticoagulation therapy in patien ts who have deep venous thrombosis (DVT) after total joint arthroplasty can be shortened with a minimal risk of recurrence. Design: A case series. Setting: Kingston General Hospital, a university-affiliated tertiary care c entre. Patients: Eleven patients who were found to have DVT after total hip or kne e arthroplasty on colour duplex Doppler ultrasonography, who fulfilled the study criteria and gave their informed consent. Exclusion criteria included chronic predisposing factors for thromboembolic disease, revision arthropl asty and a previous DVT. Interventions: Anticoagulation with warfarin to achieve an International No rmalized Ratio of 2.0 to 2.5, adjusted 3 times a week until resolution of t he DVT by duplex ultrasonography. Clinical and ultrasonographic evaluation at 1 year to monitor DVT recurrence. Outcome measures: Resolution and recurrence of the DVT. Results: All patients showed resolution of the DVT at their first follow-up ultrasonography (mean 34 days postoperatively). There was no clinical or u ltrasonographic evidence of recurrence at 1 year. Conclusion: Further study of a shorter course of anticoagulation therapy in patients who suffer DVT after joint arthroplasty should be considered.