Prophylaxis and Treatment of Deep Vein Thrombosis of Lower Extremities at Total Hip Replacement: a Literature Review

About authors

1 Municipal Clinical Hospital No. 1 named after Nl Pirogov, Moscow, Russia

2 Department of Traumatology, Orthopedics and Battle-Field Surgery, Pediatric Faculty,
Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Dmitriy Ershov
Leninskiy prospekt, d.10, korp. 7, Moscow, Russia, 119049; moc.liamg@8080vohsre

Received: 2015-02-06 Accepted: 2015-04-22 Published online: 2017-01-05

This article discusses the principles of prevention and treatment of deep vein thrombosis of the lower extremities during total hip replacement (THR). Prevention of venous thromboembolism after THR should be carried out with modern drugs. Patients with hip fracture should be carried out prevention from the moment of the injury before surgery using unfractionated heparin or low molecular weight heparins. The duration of prevention after surgery should be at least 28–35 days. The combination of pharmacological and mechanical methods of prophylaxis to the most extent reduces the risk of deep vein thrombosis after THR. No need to be monitored, oral and direct mechanism of action not associated with the concentration of antithrombin III give the advantage to the new oral anticoagulants (dabigatran, rivaroxaban, apixaban) in comparison with injected low-molecular-weight heparins and unfractionated heparin. Rivaroxaban and dabigatran may be used for the treatment of deep vein thrombosis, which is also an advantage of these drugs. Performing ultrasonic angioscanning during the first 5 days after the surgery, is most likely justified for patients with decreased locomotor activity, venous thromboembolic complications or a history of abuse prevention protocol. Deep vein thrombosis after THR is secondary, so long-term treatment for several months seems unjustified.

Keywords: deep vein thrombosis, venous thromboembolic complications, sequential intermittent pneumatic compression