Prevention of thromboembolism in total hip replacement. Aspirin versus dihydroergotamine-heparin.

In a prospective and controlled study, we compared the prophylactic effect of high-dose acetylsalicylic acid (ASA) and dihydroergotamine-heparin (DHEH) in 82 patients over 50 years of age undergoing total hip replacement. The patients were screened by pulmonary scan and 125I fibrinogen uptake. Phlebography was done if the 125 I fibrinogen test was positive. According to our criteria, thromboembolism developed in 9 of 40 receiving ASA and in 5 of 42 patients receiving DHEH. The effect of ASA was limited to men; in 16 men on this therapy, none had thromboembolism versus 9 of 24 women. Twenty-two patients showed wound hematomas, but none needed surgical intervention.