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In patients undergoing surgery on hips or knees the risk of deep venous thrombosis (DVT) is 50-70%. In patients not receiving thromboprophylaxis 0.1-0.4% will die from pulmonary embolism.
Anticoagulant thromboprophylaxis treatments include:
Despite these treatments 16-30% of hip replacement patients will develop venographically proven DVTs.
The thromboprophylactic dose of low molecular weight heparin is 5000 U twice a day.LMWH reduced the risk of DVT in patients post-total hip replacement by 31-79%. LMWH was as effective as full dose heparin but had a lower incidence of bleeding.
LMWH is also a safe and effective in prevention of DVT in patients undergoing total knee replacement.
Data suggests that a synthetic heparin analogue (fondaparinux) may be superior to LMWH.