The postdischarge risk of venous thromboembolism after hip replacement. The role of prolonged prophylaxis.

This review deals with the problems of delayed thrombosis after hip arthroplasty and the possible need for prolonged prophylaxis. These problems have been considered key questions in the European Consensus Statement on venous thromboembolism. There are several factors, such as long immobilisation, venous trauma and decreased venous emptying, which all may contribute to the development of late postoperative thrombosis. There are data on frequencies of venous thromboembolism supporting the occurrence of such late complications. In 4 recent studies on prolonged prophylaxis, it was consistently shown that prophylaxis with low molecular weight heparins for 1 month significantly reduced the frequency of deep venous thrombosis compared with conventional prophylaxis during hospitalisation in patients undergoing elective hip arthroplasty.