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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 3, 306-307.
doi: 10.1302/0301-620X.90B3.19935  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Ninety-day mortality after elective total hip replacement

1549 PATIENTS USING ASPIRIN AS A THROMBOPROPHYLACTIC AGENT

M. Parry, BSc, MBChB, MRCS, Specialist Registrar, Trauma and Orthopaedic Surgery1; V. Wylde, BSc, Research Assistant1; and A. W. Blom, MD, PhD, FRCS(Tr & Orth), Head of Orthopaedic Surgery1

1 University of Bristol University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.

Correspondence should be sent to Mr A. W. Blom; e-mail: Ashley.blom{at}nbt.nhs.uk

Thromboprophylaxis after elective orthopaedic surgery remains controversial. Recent guidelines from the National Institute for Clinical Excellence (NICE) have suggested that low molecular weight heparin should be given to all patients undergoing total hip replacement. The British Orthopaedic Association is currently debating this guideline with NICE, as it is not clear whether published evidence supports this view. We present the early mortality in our unit after total hip replacement using aspirin as chemical thromboprophylaxis. The 30-day and 90-day mortality after primary total hip arthroplasty was zero. We compare this with that reported previously from our unit without using chemical thromboprophylaxis. With the introduction of routine aspirin thromboprophylaxis, deaths from cardiovascular causes have dropped from 0.75% to zero.

These results demonstrate that there is a strong argument for the routine administration of aspirin after elective total hip replacement.




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J. Daniel, A. Pradhan, C. Pradhan, H. Ziaee, M. Moss, J. Freeman, and D. J. W. McMinn
Multimodal thromboprophylaxis following primary hip arthroplasty: THE ROLE OF ADJUVANT INTERMITTENT PNEUMATIC CALF COMPRESSION
J Bone Joint Surg Br, May 1, 2008; 90-B(5): 562 - 569.
[Abstract] [Full Text] [PDF]

eLetters:

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Controversy surrounding thromboprophylaxis
Rohit Gupta
J Bone Joint Surg Br Online, 6 Mar 2008 [Full text]
More detail needed
Shyan Lii Goh
J Bone Joint Surg Br Online, 14 Mar 2008 [Full text]
Ninety-day mortality after elective total hip replacement: role of post-operative mobilisation
KC Kong, et al.
J Bone Joint Surg Br Online, 12 Jun 2008 [Full text]

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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General