Venous thromboembolism after total hip arthroplasty diagnosed by enhanced computed tomography:comparison of selective thromboprophylaxis and no thromboprophylaxis.

Total hip arthroplasty (THA is the most effective treatment for advanced or end‑stage hip osteoar‑ thritis. However venous thromboembolism (VTE remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of antico‑ agulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagu‑ lants 100 patients who received a factor Xa inhibitor (fondaparinux 100 patients who received low molecular weight heparin (enoxaparin and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding weight and/or hemoglobin concentration. Enhanced 64‑slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15ｵ 9.0ｵ 6.0ｵ and 6.4ｵ respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0ｵ minor bleeding in 2 cases (2.0ｵ persistent wound drainage in 3 cases (3.0ｵ and eruption in 1 case (1.0ｵ. The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0ｵ and progression of anemia in 1 case (1.0ｵ. The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.