Authors’ reply

Abstract

1. Mehta KV, Lee HC, Loh JS. Mechanical thromboprophylaxis for patients undergoing hip fracture surgery. J Orthop Surg (Hong Kong) 2010;18:287–9. 2. Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Reddy DJ. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev 2008;4:CD005258. 3. Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Tsolakis IA, et al. Can combined (mechanical and pharmacological) modalities prevent fatal VTE? Int Angiol 2011;30:115–22. 4. Yokote R, Matsubara M, Hirasawa N, Hagio S, Ishii K, Takata C. Is routine chemical thromboprophylaxis after total hip replacement really necessary in a Japanese population? J Bone Joint Surg Br 2011;93:251–6. 5. Woolson ST, Watt JM. Intermittent pneumatic compression to prevent proximal deep venous thrombosis during and after total hip replacement. A prospective, randomized study of compression alone, compression and aspirin, and compression and low-dose warfarin. J Bone Joint Surg Am 1991;73:507–12. did not receive dual (mechanical and chemical) thromboprophylaxis. In a variety of patient groups (including orthopaedics), multimodal prophylaxis can reduce deep vein thrombosis and pulmonary embolism rates more effectively than single modalities.2,3 However, in elective hip replacement, mechanical prophylaxis combined with enoxaparin,4 warfarin,5 or fondaparinux4 showed no significant reduction in deep vein thrombosis rates, compared to mechanical prophylaxis alone.