VenaFlow plus Lovenox vs VenaFlow plus aspirin for thromboembolic disease prophylaxis in total knee arthroplasty.
Two hundred seventy-five patients undergoing unilateral total knee arthroplasty were prospectively randomized to receive spinal epidural anesthesia (SEA), a VenaFlow calf compression device, and enoxaparin (group A) or SEA, VenaFlow, and aspirin (group B). Aspirin was started on the day of surgery, whereas enoxaparin was started 48 hours after surgery. Anticoagulants were continued for 4 weeks after surgery. All patients had an in-hospital ultrasound screening test on postoperative days 3 to 5 and a second follow-up ultrasound 4 to 6 weeks after surgery. The overall deep venous thrombosis rates in groups A and B were 14.1% and 17.8% (P = not significant), respectively. When used in combination with pneumatic compression devices and SEA, enoxaparin was not superior to aspirin in preventing deep venous thrombosis after total knee arthroplasty.
Westrich
Geoffrey H
GH
Hospital for Special Surgery-Weill Medical College, Cornell University, New York City, New York, USA.
Bottner
Friedrich
F
Windsor
Russell E
RE
Laskin
Richard S
RS
Haas
Steven B
SB
Sculco
Thomas P
TP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D017984:Enoxaparin; D005343:Fibrinolytic Agents; D001241:Aspirin