The efficacy of low-dose heparin--warfarin anticoagulation prophylaxis after total hip replacement arthroplasty.

The prime therapeutic objective of prophylactic anticoagulation for patients undergoing total hip replacement is to reduce to a minimum fatalities from pulmonary embolism. Our low-dose heparin-warfarin prophylactic anticoagulation protocol affords significant protection in this regard (one fatal pulmonary embolism in 796 cases) without the use of venography or other objective tests to check for deep venous thrombosis and for all patients including those with venous disease or a history of prior thromboembolic disease. The 13.1% hematoma rate (5.0% late major) is a small, nonlethal, and acceptable price to pay for this protection.