Electronic Letters to:

Arthroplasty: L. A. Cusick and D. E. Beverland The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients J Bone Joint Surg Br 2009; 91-B: 645-648 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Use of aspirin in thromboprophylaxis

Sunil GARG, United Kingdom   (20 May 2009)

Use of aspirin in thromboprophylaxis 20 May 2009
Sunil GARG, Specialist Registrar, T & O Queen Mary's Sidcup, United Kingdom Send letter to journal: Re: Use of aspirin in thromboprophylaxis sunil_garg9{at}hotmail.com Sunil GARG, et al.	Sir, I read this paper with interest and congratulate the authors for their brilliant study which brings out some of the salient features of current confusion regarding thromboprophylaxis in hip and knee arthroplasty. However, the authors have contradicted themselves by concluding that "Our study suggests that the use of aspirin is reasonable". All the patients in this study who had pulmonary embolism (fatal and non-fatal) were on aspirin and hence the conclusion drawn is unreasonable. To draw definitive conclusions on the use of any of these prophylactic agents calls for a study with large numbers in each arm, as pointed out by the authors. Such a study is clearly possible in the United Kingdom as the number of total hip replacements and total knee replacements carried out in the UK is far more than in any other country in the world. The National Institute of Clinical Excellence (NICE) should stop recommending the use of any chemical thromboprophylactic agent until we have robust evidence to use them on the basis of clinical end points. S. Garg, Specialist Registrar, Trauma & Orthopaedics, Queen Mary's Hospital, Sidcup, UK.