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June 15, 1984

Deep Venous Thrombosis in Total Hip Replacement-Reply

Author Affiliations

Marshfield Medical Foundation Marshfield, Wis

JAMA. 1984;251(23):3081-3082. doi:10.1001/jama.1984.03340470017013

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In Reply.—  Dr Leeman is correct in calling attention to the variable that may confound results in deep venous thrombosis. The evidence is apparent that the type of anesthesia employed during total hip arthroplasty does influence the extent of postoperative deep venous thrombosis. We had no opportunity to evaluate this aspect as all the patients received a general anesthetic.I have one word of caution; elective total hip arthroplasty and emergency surgery for fractured hips are two separate problems. A significant number of patients who have suffered a fractured hip may have developed a deep venous thrombus before surgical intervention. Therefore, comparison between these two groups in regard to evidence of venous thrombosis is inappropriate.We thank Dr Leeman for his kind remarks and hope that he and his colleagues will find our suggested therapeutic regimen helpful.