Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage
hip osteoarthritis. 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
anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no
anticoagulants, 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%, 9.0%, 6.0%, and 6.4%, 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%), minor
bleeding in 2 cases (2.0%), persistent
wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of
enoxaparin therapy were persistent
wound drainage in 1 case (1.0%) and progression of
anemia in 1 case (1.0%). 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.