Effect of high-dose corticosteroids on the incidence of deep vein thrombosis after total hip replacement.

Fifty patients receiving uncemented total hip prostheses were examined by venography of the legs on the 2nd postoperative day. The patients were randomly divided into two groups, a non-steroid group (n = 26) and a steroid group (n = 24). Both groups received dextran thrombo-prophylaxis. The patients in the steroid group were treated with high-dose corticosteroids. The incidence of deep vein thrombosis (DVT) was 38% (19/50). No patients had clinical signs or symptoms of DVT. All thrombi were located distally in the leg. DVT was bilateral in nine patients, in the operated leg in three, and in the non-operated leg in seven. The administration of high-dose corticosteroids did not influence the incidence or pattern of DVT. All patients were followed up clinically and plethysmographically up to 12 months after surgery. Distally located asymptomatic DVT were not given specific treatment. The postoperative course was uneventful except for one patient in each group who developed clinically, apparent DVT more than 3 weeks after operation, although the initial venographic studies were normal.