A Meta-Analysis of Thromboembolic Prophylaxis Following Elective Total Hip Arthroplasty*

Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty

“…Placebo and five prophylactic agents were evaluated (low-molecular-weight heparin, warfarin, aspirin, low-dose heparin, and pneumatic compression devices). There were no differences in the rates of fatal PE or allcause mortality between the groups [18].…”

“…The previously discussed meta-analyses by Murray et al [39] and Freedman et al [18] are subject to limitations. They included patients who underwent THA over three decades during which the rate of mortality and fatal PE changed substantially [35].…”

“…Freedman et al [18] published a meta-analysis of thromboembolic prophylaxis after elective THA that included randomized, controlled trials published from 1966 to 1998. Fifty-two studies with 10,929 patients were included.…”

“…Bleeding is more common with Group A anticoagulants. Bleeding [5,8,17,18,23,26,41,42,52,55,61] can lead to death from multiple causes, including shock, renal failure, stroke, myocardial infarction, infection, and sepsis. It is likely complications of bleeding contributed to the increased mortality.…”

CT Pulmonary Angiography After Total Joint Arthroplasty: Overdiagnosis and Iatrogenic Harm?

“…The incidence of DVT when no prophylaxis is given ranges from 40% to 84% in patients undergoing TKA and 39% to 74% in patients undergoing THA [12,30]. On the other hand, fatal PE associated with TJA is less common, ranging in incidence from 0.19% to 3.4% [19,20,30].…”