Controversies in the prevention of deep vein thrombosis with total hip arthroplasty.

Thromboembolic disease is a serious problem that is growing because both total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients are now being discharged from the hospital as early as the fourth postoperative day. The current estimate is that 50,000 deaths a year in the United States can be attributed to this disease process, and it is an equally large problem in other countries such as Great Britain (Table 1). Thromboembolic disease is asymptomatic in the vast majority of patients undergoing joint replacement. Approximately one in six patients develops the condition following THA or TKA.