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Preventing Blood Clots Before and During Total Hip Replacement All That's Needed

Back in the 1970s blood clots after total hip replacement (THR) were a major problem. Up to eight percent of the patients operated on were affected. Today, thanks to prevention measures, this figure has dropped to less than one percent.

In this study researchers looked at prevention measures used before and during the operation instead of after. Patients were taken off any kind of drug that could cause blood to clot. Patients donated their own blood ahead of time. Changes were made in how the surgery was performed to minimize the risk of clotting.

After surgery patients were given special elastic stockings and a machine to compress the legs. Exercises to keep the feet and lower legs moving were added. Everyone was up and walking on postoperative day 1. Patients were started on blood thinners after the THR. All of these actions taken together are called multimodal prophylaxis.

The results were excellent. The rate of dangerous clots was decreased. In fact the rate was the lowest ever reported. There was a cost savings from not using anticoagulation (drug) therapy. And there were fewer problems without the routine use of anticoagulants.

The authors concluded that multimodal prophylaxis before, during, and after THR can safely replace drugs that increase the risk of bleeding.


Alejandro González Della Valle, MD, et al. Venous Thromboembolism is Rare with a Multimodal Prophylaxis Protocol After Total Hip Arthroplasty. In Clinical Orthopaedics and Related Research. March 2006. No. 444. Pp. 146-153.

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