title: Postoperative prophylactic effect of fondaparinux for prevention of deep venous thrombosis after cemented total hip replacement: a comparative study.
abstract: The aim of this study was to estimate the effective administration procedure of fondaparinux for prevention of venous thromboembolism after cemented total hip replacement (THR) in Japanese patients. The study included 471 Japanese patients. The dose regimens were 2.5 mg daily for 14 days (2.5 mg/14 day group) or 10 days (2.5 mg/10 day group), 1.5 mg daily for 10 days (1.5 mg group), 2.5 mg daily for the first 3 postoperative days and 1.5 mg daily for the subsequent 7 days (Mixed group), and no administration of fondaparinux (Control group). Deep venous thrombosis (DVT) was diagnosed by ultrasonography on postoperative day 3 or 4 and day 14. The 2.5 mg/14 day, 2.5 mg/10 day and Mixed groups were regarded as one group in the assessment on postoperative day 3 or 4, and denoted as the 2.5 mg group. The incidence of DVT on postoperative day 3 or 4 in the 2.5 mg group was significantly lower than that in the Control and 1.5 mg groups. On postoperative day 14, the incidence of DVT in the 1.5 mg and Mixed groups was significantly lower than that in the Control group in both the intention-to-treat and per-protocol analyses. The incidence in the 2.5 mg/10 day and 2.5 mg/14 day groups was significantly lower than that in the Control group in only the per-protocol analysis. The results suggest that the administration protocol of the Mixed group is effective in preventing DVT in Japanese patients undergoing cemented THR.
authors.affiliation: Department of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, 79-1 Okimachi, Yamagata, Yamagata 990-8545, Japan. hiroyuki.kawaji@ameria.org
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawaji
authors.forename: Masaji
authors.initials: M
authors.lastname: Ishii
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Hamasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Kan
authors.initials: K
authors.lastname: Sasaki
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Dairaku
authors.forename: Michiaki
authors.initials: M
authors.lastname: Takagi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D002484:Cementation; D004305:Dose-Response Relationship, Drug; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D013997:Time Factors; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D001843:Bone Cements; D011134:Polysaccharides; D000077425:Fondaparinux