A shortened course of anticoagulation to treat deep venous thrombosis after total joint arthroplasty.

OBJECTIVE To study whether the course of anticoagulation therapy in patients who have deep venous thrombosis (DVT) after total joint arthroplasty can be shortened with a minimal risk of recurrence. DESIGN A case series. SETTING Kingston General Hospital, a university-affiliated tertiary care centre. PATIENTS Eleven patients who were found to have DVT after total hip or knee arthroplasty on colour duplex Doppler ultrasonography, who fulfilled the study criteria and gave their informed consent. Exclusion criteria included chronic predisposing factors for thromboembolic disease, revision arthroplasty and a previous DVT. INTERVENTIONS Anticoagulation with warfarin to achieve an International Normalized Ratio of 2.0 to 2.5, adjusted 3 times a week until resolution of the DVT by duplex ultrasonography. Clinical and ultrasonographic evaluation at 1 year to monitor DVT recurrence. OUTCOME MEASURES Resolution and recurrence of the DVT. RESULTS All patients showed resolution of the DVT at their first follow-up ultrasonography (mean 34 days post-operatively). There was no clinical or ultrasonographic evidence of recurrence at 1 year. CONCLUSION Further study of a shorter course of anticoagulation therapy in patients who suffer DVT after joint arthroplasty should be considered.