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Arch Orthop Trauma Surg. 2014 May;134(5):679-83. doi: 10.1007/s00402-014-1939-2. Epub 2014 Feb 18.

Administration of enoxaparin 24 h after total knee arthroplasty: safer for bleeding and equally effective for deep venous thrombosis prevention.

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1
Department of Orthopedics, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, 54 Youdian Road, Shangcheng District, Hangzhou, 310006, China.

Abstract

BACKGROUND:

The purpose of this study was to determine the safety and effectiveness, as assessed by risk of bleeding and incidence of deep venous thrombosis (DVT), of administering delayed low-molecular-weight heparin (LMWH) after total knee arthroplasty.

METHODS:

A prospective study of 210 consecutive patients undergoing primary unilateral total knee arthroplasty was undertaken. The patients were randomized into two groups: one of which was managed according to a standard LMWH program (LMWH-s group) and the other with delayed LMWH (LMWH-p). LMWH was initiated 12 h after wound closure in the LMWH-s group, and 24 h after wound closure in the LMWH-p group.

RESULTS:

The total blood loss in the first three postoperative days was calculated and all complications were recorded. The mean total blood loss was 435 and 387 mL in the LMWH-s group and LMWH-p group, respectively (p < 0.01). No significant difference in the incidence of symptomatic DVT was observed. The mean length of hospital stay was 7.29 days in the LMWH-s group and 6.56 days in the LMWH-p group (p < 0.05).

CONCLUSIONS:

After total knee arthroplasty, LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT.

PMID:
24535621
DOI:
10.1007/s00402-014-1939-2
[Indexed for MEDLINE]

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