Format

Send to

Choose Destination
J Arthroplasty. 2014 Feb;29(2):320-4. doi: 10.1016/j.arth.2012.11.003. Epub 2013 Oct 25.

Complications of perioperative warfarin therapy in total knee arthroplasty.

Author information

1
Royal Infirmary of Edinburgh, United Kingdom.
2
Bradford Royal Infirmary, United Kingdom.
3
Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
4
Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia; The Prince Charles Hospital, Brisbane, Queensland, Australia.
5
Brisbane Orthopaedic Specialist Services, Holy Spirit Northside Hospital, Queensland, Australia.

Abstract

Patients presenting for knee replacement on warfarin for medical reasons often require higher levels of anticoagulation peri-operatively than primary thromboprophylaxis and may require bridging therapy with heparin. We performed a retrospective case control study on 149 consecutive primary knee arthroplasty patients to investigate whether anti-coagulation affected short-term outcomes. Specific outcome measures indicated significant increases in prolonged wound drainage (26.8% of cases vs 7.3% of controls, P<0.001); superficial infection (16.8% vs 3.3%, P<0.001); deep infection (6.0% vs 0%, P<0.001); return-to-theatre for washout (4.7% vs 0.7%, P=0.004); and revision (4.7% vs 0.3%, P=0.001). Management of patients on long-term warfarin therapy following TKR is particularly challenging, as the surgeon must balance risk of thromboembolism against post-operative complications on an individual patient basis in order to optimise outcomes.

KEYWORDS:

anticoagulation; bridging; complications; heparin; total knee arthroplasty; warfarin

PMID:
24209787
DOI:
10.1016/j.arth.2012.11.003
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center