[Prevention of thromboembolic complications with adapted low-dose of antivitamins K after total hip prosthesis].
This study reports the efficacy in the prevention of thromboembolic complications of adapted low-dose oral anticoagulants following total hip replacement. 750 patients undergoing total hip replacement received oral anticoagulants as exclusive drug prophylaxis for thromboembolic complications. These patients were considered preoperatively not to present any particular risk for the development of postoperative thrombosis. Anticoagulant therapy was commenced on the evening of the operation. Eleven pulmonary embolisms (1.5 per cent) were observed, but none of them were fatal. The risk of thrombosis was evaluated in 100 of these 750 patients by means of bilateral venography of the lower limbs: 21 patients developed distal thrombosis (sural veins) and 2 patients developed 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 embolism, it is not clear that their efficacy is directly related to the prothrombin time.