The effect of intraoperative heparin administered during total hip arthroplasty on the incidence of proximal deep vein thrombosis assessed by magnetic resonance venography.

Abstract

Intraoperative, unfractionated heparin, administered intravenously before the femoral work, has demonstrated to be effective in reducing the strong thrombotic stimulus that occurs during total hip arthroplasty (THA) surgery. This randomized, double-blind, prospective study included only THA patients with significant comorbidities predisposing them to deep vein thrombosis (DVT). The 2 groups consisted of study patients who received a single dose of intravenous, intraoperative, unfractionated heparin and control patients who received a single dose of intravenous, intraoperative saline. Magnetic resonance venography was used as the DVT diagnostic tool. The overall prevalence of proximal femoral vein clots was 2.2% (3 of 134), whereas pelvic thrombosis was detected in 10.4% (14 of 134). This study demonstrated that pelvic thrombi may form following THA and that a single dose of intraoperative heparin does not prevent their formation, but may be effective at preventing ipsilateral femoral thrombi. This study strongly supports a multimodal approach to DVT prophylaxis following THA.