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


CONCLUSIONS
IPC is the preferred method of thromboprophylaxis for TKA in Asian patients.
Chin
P L
PL
Adult Reconstructive Team, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. chinpl@singnet.com.sg
Amin
M S
MS
Yang
K Y
KY
Yeo
S J
SJ
Lo
N N
NN
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D044466:Asian People; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006723:Hong Kong; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D053828:Stockings, Compression; D013923:Thromboembolism / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D017984:Enoxaparin; D005343:Fibrinolytic Agents