Abstract
Objective: Pharmacological agents and mechanical compressive devices are used for preventing venous thromboembolism (VTE) during and after total hip arthroplasty (THA) and total knee arthroplasty (TKA). In addition, elective postoperative ultrasonography is used as a screening tool to detect deep vein thrombosis (DVT) and if found, warfarin is frequently used for its treatment. We aimed to evaluate the efficacy of pharmacological agents, mechanical compressive devices, and warfarin therapy for preventing VTE during and after elective THA and TKA.
Methods: Twenty-six patients were identified to have DVT and they received therapeutic warfarin following either elective THA or TKA and were followed up for 10 months after surgery by postoperative ultrasonography and D-dimer level evaluations.
Result: The range of serum D-dimer levels were 0.44-17.54 (mean 2.55) μg/ml, 3.85-32.89 (mean 12.62) μg/ml, and 0.63-14.5 (mean 2.62) μg/ml before surgery, seven days postoperatively, and at the 10-month follow-up visit, respectively. DVT was not detected in 14 patients (54%) at three months and in 22 patients (85%) at 10 months postoperatively. Warfarin was discontinued in all except one patient (92%). There were no cases of warfarin-related bleeding complications.
Conclusion: The use of warfarin therapy to treat symptoms in patients who develop DVT in the postoperative period are effective prophylactic measures against VTE.
