Embolic complications of calf thrombosis following total hip arthroplasty

The incidence of clinically significant pulmonary embolism following total hip arthroplasty is reported in patients with venographically documented deep venous thrombosis. One hundred seventy-four patients who enrolled in a prospective evaluation of deep venous thrombosis prophylaxis underwent contrast venography 7–10 days after operation. Ten patients with proximal and 12 patients with isolated deep calf thrombosis were identified on routine venogram reading and received appropriate anticoagulant therapy, including a 6–12 week course of warfarin. There were no clinically evident embolic events and no bleeding complications in this group. A secondary blinded review of venograms several weeks later identified isolated deep calf thrombi in 13 other patients, none of whom had received warfarin after discharge. Four of the 13 patients ( P