Prolonged Enoxaparin Therapy to Prevent Venous Thromboembolism After Primary Hip or Knee Replacement

Risk of clinical pulmonary embolism after joint surgery in patients receiving low-molecular-weight heparin prophylaxis in hospital

“…This difference emphasizes that the pathophysiological pattern differs in each group of patients, which is in accordance with vascular flow studies in various groups of orthopedic patients (McNally et al 1997). Such views also agree with a recent study showing that extending prophylaxis with the same dosage of a LMWH, enoxaparin, to 1 month significantly reduced the occurrence of venous thromboembolism in patients undergoing THR, but not in patients undergoing knee replacement, indicating a different response to the same prophylactic regimen (Comp et al 2001). The optimal dosage and the timing of prophylaxis relative to surgery may differ in these 2 groups of patients, and more investigations are needed.…”

“…Studies of patients who underwent THR have indicated that extending anticoagulant prophylaxis with LMWH to 4-5 weeks postoperatively significantly reduces the incidence of venographically-detected DVT, as compared to a regimen of only 1-2 weeks (Bergqvist et al 1996, Planes et al 1996, Dahl et al 1997, Lassen et al 1998, Hull et al 2000, Comp et al 2001. Three recent meta-analyses have shown a relative reduction in venographically-proven subclinical DVT that parallels a similar reduction in postoperative clinical thromboembolic events (Cohen et al 200 1, Eikelboom et al 2001, Hull et al 2001.…”

Combined Short Course Low Molecular Weight Heparin and Calf Compression Therapy in Prevention of Deep Vein Thrombosis after Total Knee Replacement: A Randomized Prospective Study

“…Our findings support previous larger sample sized studies in which prolonged therapy with LMWH (greater than 7 days) was not associated with significant reductions in incidence of VTE, major bleeding or death compared with short course LMWH therapy (<7 days) amongst post operative patients including TKR [24,25]. A notable proportion of patients in these study cohorts displayed characteristics (such as age >61, arthroscopic surgery and BMI>25) that would place them at moderate to high risk of DVT/VTE according to existing major orthopedic guidelines [6,26,27].…”

Potent Anticoagulants are Associated with a Higher All-Cause Mortality Rate After Hip and Knee Arthroplasty

“…When 3-month mortality was not reported but appeared likely to have been collected, the authors were contacted to provide the information. The authors of four publications responded with the necessary information [31,33,45,57], and the remaining three studies [1,4,9] were excluded from the analysis.…”