Clinical outcomes with Preoperative and Postoperative Start of Thromboprophylxis in Total Hip Arthroplasty

Total hip arthroplasty (THA) leads to venous stasis, vessel injury, and hypercoagulability which favor thrombosis generation. Therefore, the majority of patients receive anticoagulants to prevent thromboembolism. These agents’ increases the risk of bleeding complications. Thus, the questions of type of drugs, drug dose, duration of treatment and timing of prophylaxis are controversial issues. This thesis aimed to evaluate the clinical consequences of starting prophylaxis before or after surgery. We applied four different research designs to answer if pre or a postoperative start of low-molecular-weight-heparin thromboprophylaxis induced differences in blood loss, bleeding events, thromboembolic episodes and other clinical complications. We could not detect important clinical differences between the two regimens, and THA induced the same biochemical pattern with preoperative and postoperative start with thromboprophylaxis. The results support the current trend of starting chemical thromboprophylaxis after surgery for the majority of THA patients