Intraoperative adjusted-dose heparin thromboembolic prophylaxis in primary total hip arthroplasty

M. H. Huo, E. A. Salvati, N. E. Sharrock, P. M. Pellicci, T. P. Sculco, G. Go, R. Mineo, W. W. Brien

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Abstract

Intraoperative, fixed, intermittent, low-dose intravenous heparin prophylaxis has been reported to significantly reduce the incidence of thromboembolic disease from 24.3% to 8.3% after primary total hip arthroplasty (THA). This study examined the potential efficacy of adjusted- dose intraoperative heparin administration, keeping the activated clotting time at 30%-50% greater than normal. It was hypothesized that prolongation of clotting parameters in a uniform manner would further decrease the incidence of thromboembolic disease postoperatively. Sixty-one patients completed the protocol. The overall incidence of thromboembolic disease was 9.8%. Five patients had a positive postoperative venogram: four in the calf and one in the proximal deep thigh vein. One patient had a symptomatic nonfatal pulmonary embolus diagnosed by ventilation-perfusion scan. There were no complications related to heparin administration. This approach was therefore equally as effective as the fixed-dose regimen, and it further confirmed the efficacy and safety of an intraoperative heparin prophylaxis regimen. The extra efforts required to maintain a constant intraoperative level of anticoagulation did not prove advantageous over the simpler, fixed-dose regimen in reducing the incidence of thromboembolic disease after primary THA.

Original languageEnglish (US)
Pages (from-to)188-196
Number of pages9
JournalClinical orthopaedics and related research
Issue number277
StatePublished - Jan 1 1992

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Huo, M. H., Salvati, E. A., Sharrock, N. E., Pellicci, P. M., Sculco, T. P., Go, G., Mineo, R., & Brien, W. W. (1992). Intraoperative adjusted-dose heparin thromboembolic prophylaxis in primary total hip arthroplasty. Clinical orthopaedics and related research, (277), 188-196.