ABSTRACTA prospective, randomized, double-blind trial was performed in
total hip replacement patients to document the risk of
deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving
enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with
enoxaparin (N=90) or receive placebo (N=89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P=0.018) of DVT in the
enoxaparin group (7.1%; N=6) compared with the placebo group (19.3%; N=17). These findings were confirmed by perprotocol analysis in 155 patients. Minor
bleeding episodes occurred in three patients in the
enoxaparin group and one in the placebo group. Thus,
total hip replacement patients have a significant risk of developing DVT after hospital discharge. Continued prophylaxis with
enoxaparin is effective in reducing this risk.