title: Extended thromboprophylaxis after hip or knee replacement.
abstract: Early discharge from the hospital after total joint arthroplasty has increased the need for extended outpatient thromboprophylaxis. Multiple controlled clinical trials and several meta-analyses of these data have examined various agents in different regimens. These data indicate that extended prophylaxis with a low-molecular-weight heparin after knee or hip arthroplasty significantly reduces the number of venous thromboembolic episodes with no increases in major bleeding. The data also show that > 98% of patients given long-term low-molecular-weight heparin prophylaxis remain free from symptomatic deep venous thrombosis and pulmonary embolism. Therefore, to minimize patient risk safely and cost-effectively, extended prophylaxis with low-molecular-weight heparin once-daily for 4 weeks after surgery should be considered for patients undergoing total joint arthroplasty.
authors.affiliation: Charleston Orthopaedic Associates, Charleston, SC, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Friedman
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D011183:Postoperative Complications; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight