Thromboembolic prophylaxis for total knee arthroplasty in Asian patients: a randomised controlled trial

J Orthop Surg (Hong Kong). 2009 Apr;17(1):1-5. doi: 10.1177/230949900901700101.

Abstract

Purpose: To compare the efficacy and safety of different modes of thromboembolic prophylaxis for elective total knee arthroplasty (TKA) in Asian patients.

Methods: 440 low-risk patients undergoing TKA were randomised into 4 equal groups: (1) no prophylaxis (control), (2) graduated compression stockings (GCS), (3) intermittent pneumatic compression (IPC), and (4) low-molecular-weight heparin (enoxaparin). Duplex ultrasonography was used as an assessment tool.

Results: The deep vein thrombosis point prevalence was highest in the control group (22%), which was significantly higher than in patients receiving IPC (8%, p=0.032) or enoxaparin (6%, p=0.001). One patient each in the control and GCS groups developed a non-fatal pulmonary embolism. Patients on enoxaparin received more blood transfusions and 2 of them had major bleeding complications.

Conclusion: IPC is the preferred method of thromboprophylaxis for TKA in Asian patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Asian People*
  • Enoxaparin / therapeutic use*
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Hong Kong
  • Humans
  • Intermittent Pneumatic Compression Devices*
  • Male
  • Middle Aged
  • Stockings, Compression*
  • Thromboembolism / ethnology
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control*
  • Treatment Outcome

Substances

  • Enoxaparin
  • Fibrinolytic Agents