Prevention of venous thrombosis after total hip arthroplasty. Antithrombin III and low-dose heparin compared with dextran 40.

Thromboembolic Disease After Combined Anterior/Posterior Reconstruction for Adult Spinal Deformity

“…Thromboembolic disease (TED) is a well-known complication after orthopedic operations, with rates of deep venous thrombosis (DVT) and pulmonary embolism (PE) in nonprophylaxed arthroplasty patients reaching 20% to 84% [1][2][3][4][5] and 1% to 7.9%, [5][6][7][8] respectively. This has led to widespread, aggressive postoperative DVT prophylaxis-usually with both mechanical and chemical means.…”

Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?

“…(1)(2)(3)(4)(5) Earlier studies reported a higher risk of DVT in cemented TKR and THR. (6)(7)(8)(9)(10) Several studies have also demonstrated thrombogenic properties of bone cement that may contribute towards the development of DVT. (15)(16)(17) In addition, the hypercoagulable state after a traumatic femoral neck fracture would put these patients at greater risk for thromboembolism.…”

“…(1)(2)(3)(4)(5) In earlier studies reported in the 1990s, the cemented prosthesis was associated with a higher incidence of deep vein thrombosis (DVT) in total knee replacements (TKR) and total hip replacements (THR). (6)(7)(8)(9)(10) Subsequent studies, however, provided contradictory results and there was a lack of new data thereafter. (11,12) Notably, all of these studies (6)(7)(8)(9)(10)(11)(12) used healthy patients for elective surgery, while patients with traumatic femoral neck fractures are potentially in a procoagulable state due to the nature of the trauma sustained in the initial injury.…”

“…(6)(7)(8)(9)(10) Subsequent studies, however, provided contradictory results and there was a lack of new data thereafter. (11,12) Notably, all of these studies (6)(7)(8)(9)(10)(11)(12) used healthy patients for elective surgery, while patients with traumatic femoral neck fractures are potentially in a procoagulable state due to the nature of the trauma sustained in the initial injury. (13,14) In addition, several recent studies have reported on the possible thrombogenic properties of polymethyl methacrylate cement and the activation of platelet aggregation and cytokines, which could contribute to the pathogenesis of DVT.…”

Prophylaxis Against Venous Thromboembolism After Total Hip and Knee Arthroplasty

“…Unfortunately, recommendations of professional associations have historically not been in agreement, and the ideal prophylaxis is yet to be determined. It must represent a risk-benefit balance in which the fear of fatal pulmonary embolism is weighed against the consideration for the morbidity of persistent wound drainage and hematoma [14][15][16] , secondary infection, and reoperation resulting from bleeding associated with perioperative anticoagulant use.…”