title: [Efficacy and safety of prophylactic preoperative administration of low-dose warfarin in cemented total knee prostheses].
abstract: One hundred and fifty six consecutive cemented total knee arthroplasties (TKA) in 147 patients (39 males, 108 females, mean age: 67) received preoperatively low-dose-warfarin for thromboembolic prophylaxis. Warfarin 10 mg was given the night before surgery and warfarin 5 mg the night of surgery. Thereafter, the dosage was adjusted to maintain a prothrombin time between 1.2-1.5 times control (INR = 2.0-3.0). The screening for any deep vein thrombosis (DVT) in the operated limb was by ascending venography. The reported incidence of DVT after TKA without prophylaxis is superior to 50%, more than 10% of those are proximal DVT. In this study, the overall incidence of DVT is down to 22.4%. Only five patients (3.4%) had a proximal DVT. There were no deaths and no clinical pulmonary embolisms. Patients with venous insufficiency had a significantly higher incidence of DVT (36.7%, p = 0.05). The average blood loss was 406 ml. Three major local bleedings occurred (2.0%). At one year follow-up, there were no infections. Low dose warfarin is efficacious in reducing DVT formation with TKA. It is safe and does not create excessive bleeding in cemented TKA.
authors.affiliation: Service de Chirurgie Orthopédique, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Québec, Canada.
authors.forename: G Y
authors.initials: GY
authors.lastname: Laflamme
authors.forename: G H
authors.initials: GH
authors.lastname: Laflamme
authors.forename: G D
authors.initials: GD
authors.lastname: Paiement
authors.forename: P
authors.initials: P
authors.lastname: Beaumont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014859:Warfarin
vernacular_title: Efficacité et sécurité de la prophylaxie avec warfarine faible dose débutée en pré-opératoire lors de prothèses totales de genou cimentées.