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  5. Thromboprophylaxis in lower limb immobilisation

Thromboprophylaxis in lower limb immobilisation

Research overview

  • What the study is about 
  • The problem it addresses 
  • Who it’s for 

In the UK, around 70,000 people injure their leg and need to wear a cast or brace to recover. While their leg is immobilised, they are at risk of developing blood clots. These blood clots are known as venous thromboembolism, or VTE.  

VTE can cause symptoms, such as pain, leg swelling or shortness of breath. It can also cause serious long-term health problems and on rare occasions can lead to death. We don’t know exactly but for every 50 patients, we think VTE occurs in 1 or 2 people, who wear a cast or brace after a leg injury. 

VTE after leg injury can be prevented by taking an anticoagulant medicine - these are blood thinning medicines that reduce the likelihood of blood clotting. 

The TiLLI Study is looking at the most effective methods of preventing VTE after leg injury.  

Why this study matters 

The gap in knowledge or care 

Why now 

Potential relevance to care / communities we serve  

In the NHS, people who are at risk of VTE are given an anticoagulant injection called Low Molecular Weight Heparin (LMWH). These injections can be uncomfortable and sometimes difficult to give.  

Anticoagulants are available in other forms, including oral tablets, known as Direct Oral AntiCoagulants (DOACs). DOACs are commonly given to people undergoing hip or knee replacement surgery. DOACs are easier to administer and less expensive for the NHS, but we don’t know whether they are as effective at preventing VTE in people who have had their leg immobilised. 

TiLLI will find out if DOACs are as effective, or better than LMWH, in preventing VTE in people who have had a cast or brace put on their leg. 

What we’re doing 

Study design (high level) 

Population or data source 

Timescale 

TiLLI is a randomised controlled trial for people aged 16 years and above with leg injuries. People who take part in TiLLI are allocated to receive LMWH or DOAC, we will collect data from them for 90-days then compare the information from the groups to see which treatment is better. When comparing groups, we’ll be looking at lots of different things including:  

How effective the anticoagulant medicine was at preventing blood clots 

Whether people experienced side effects due to their anticoagulant medicine 

What people thought of their anticoagulant medicine 

Whether people had to seek extra healthcare support 

The impact that injuring their leg had on their lifestyle 

We’ll then use all this information to answer our research question: what is the most effective and cost-effective method of preventing blood clots in people who have injured their leg and need to have it immobilised. 

Who is involved 

Include: 

Lead investigators 

Key partners (NHS, industry, charities, international groups) 

There are lots of NHS hospitals across the UK who are involved in the TiLLI study (spreadsheet and map).   

Current status

Recruiting 

Data collection underway 

Analysis phase 

We are currently looking for more people to take part in the TiLLI study and expect to continue to recruit until November 2027.  

Get involved / Find out more 

Participant recruitment link 

Contact email 

Related publications or protocols 

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