Dextran prophylaxis in total hip replacement: A scintigraphic evaluation of the incidence of deep vein thrombosis and pulmonary embolus.

The results of a prospective randomised study in a series of 106 patients undergoing Charnley total hip arthroplasty are discussed. All were consecutive and no one was excluded on the grounds of previous medical history. Fifty-five received prophylactic Dextran while 51 acted as controls. A total of 867 separate studies were performed on these patients. Radionuclide venography was employed to detect deep vein thrombosis and perfusion lung scanning for pulmonary emboli. Eighteen per cent of the control patients and 27% of the Dextran patients developed deep vein thrombosis. Pulmonary emboli occurred in 16% of the patients in each group. The overall incidence of thromboembolic disease was 27% in the control and 36% in the Dextran group. A prophylactic effect of Dextran was not demonstrated.