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Journal of Bone and Joint Surgery, 1967;49:81-89.
© 1967 by The Journal of Bone and Joint Surgery, Inc

The Prevention of Thromboembolic Disease By Prophylactic Anticoagulation

A CONTROLLED STUDY IN ELECTIVE HIP SURGERY

WILLIAM H. HARRIS M.D.1, EDWIN W. SALZMAN M.D.1, and ROMAN W. DESANCTIS M.D.1

1 From the Departments of Orthopaedic Surgery, Surgery, and Medicine, Harvard Medical School and Massachusetts General Hospital, Boston

A statistically significant protective effect against the occurrence of thromboembolic disease has been demonstrated in a controlled series of 169 elective hip operations in 137 consecutive patients by the use of prophylactic anticoagulation with warfarin.

No case of pulmonary embolism and only five cases of thrombophlebitis occurred in the seventy patients treated with warfarin, an over-all incidence of 7 per cent.

Seven cases of pulmonary embolism and twenty-three cases of thrombophlebitis occurred in the sixty-seven patients not treated with warfarin. Four patients had both embolism and phlebitis. The over-all incidence of thromboembolic disease in this group was 39 per cent.

The slight increase in risk of bleeding inherent in the use of an anticoagulant does not offset its obvious advantage in preventing thromboembolic complications.

Prophylactic anticoagulation is recommended in all patients undergoing mold arthroplasty unless a specific contra-indication is present.


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