Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial.

Background: Clinical and experimental studies have suggested that the maximum risk of thrombogenesis occurs during, rather than after, total hip arthroplasty. With use of conventional cementing techniques, insertion of a femoral component results in marrow embolization of tissue thromboplastin into the veins of the proximal part of the femur, leading to activation of the clotting cascade and thrombogenesis. We hypothesized that an operative technique designed for the prevention of fat and bone-marrow embolism can also reduce the incidence of postoperative deep-vein thrombosis and pulmonary embolism.