Post-op DVT prophylaxis after hip arthroplasty combines pharmacologic (LMWH such as enoxaparin, DOAC, or fondaparinux) with mechanical (SCDs when in bed) AND early ambulation as cleared by surgery. Choice 1 (massage) can dislodge an undetected clot and is dangerous. Choice 2 (strict bed rest) maximizes Virchow's triad (stasis) and INCREASES DVT risk. Choice 4 (hold one if doing the other) is wrong — multimodal prophylaxis is additive in high-risk patients (hip, knee, hip fracture, major cancer surgery).
In-depth explanation
Hip and knee arthroplasty are the highest-risk procedures for DVT — multimodal prophylaxis is standard. The "stop one prophylaxis when starting another" trap is wrong; pharmacologic AND mechanical AND early ambulation are added together. The single most lethal DVT prevention error remains "patient is ambulating now, hold the LMWH" — it is not.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.