Prevention of venous thrombosis with minidose warfarin after joint replacement.

Minidosewarfarin (a fixed dose of 1 mg warfarin a day) is simple, seems to be safe, prevents leg vein thrombosis after elective gynaecological surgery, and prevents subclavian veinThrombose after central venous line insertion and its use in elective major joint replacement is reported.

Abstract

Without prophylaxis 5-10% of patients having elective hip replacement develop clinically important venous thrombosis and about 5% develop symptomatic embolism, which is fatal in up to 0-5%.' Effective preventive methods exist, but many orthopaedic surgeons do not use them systematically because they tend to be complex, cumbersome, dangerous, or not generally available.'Minidose warfarin (a fixed dose of 1 mg warfarin a day) is simple, seems to be safe, prevents leg vein thrombosis after elective gynaecological surgery,2 and prevents subclavian vein thrombosis after central venous line insertion.3We report a pilot study of its use in elective major joint replacement.