title: Safety of fondaparinux versus enoxaparin after TKA in Japanese patients.
abstract: Fondaparinux and enoxaparin are useful for preventing venous thromboembolism after total knee arthroplasty (TKA), but both drugs have associated complications. The purpose of this study was to clarify the risks associated with use of these drugs in Japanese patients who underwent TKA.A total of 575 patients (935 knees) underwent TKA and were retrospectively reviewed; 277 patients (454 knees) were treated with fondaparinux and 298 patients (481 knees) were treated with enoxaparin. The authors investigated the incidences of deep venous thrombosis of the lower limbs and pulmonary embolism to evaluate venous thromboembolism, knee enlargement compared with the preoperative size, incidence of subcutaneous knee hematoma, and other complications. No significant differences were observed between the 2 drugs regarding the incidences of deep venous thrombosis and pulmonary embolism. However, fondaparinux use resulted in knee enlargement (P<.0005) and subcutaneous hematoma of the knee (P=.035) significantly more often than enoxaparin use. Conversely, enoxaparin use significantly caused the elevation of alanine aminotransferase (one of the liver enzymes) at a higher rate than fondaparinux (30.1% vs 8.3%, respectively; P<.0001). However, the increased alanine aminotransferase levels were transient, and no patient exhibited symptoms of abnormal liver function, such as jaundice or cutaneous pruritus.Fondaparinux and enoxaparin were both effective in preventing venous thromboembolism in Japanese patients undergoing elective TKA. However, both drugs had some adverse effects. It is important to be aware of these potential risks when prescribing these drugs.
authors.affiliation: Department of Orthopedic Surgery, Nihon University School of Medicine, Tokyo, Japan. kunihiro619@hotmail.com
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosaka
authors.forename: Shu
authors.initials: S
authors.lastname: Saito
authors.forename: Takao
authors.initials: T
authors.lastname: Ishii
authors.forename: Takanobu
authors.initials: T
authors.lastname: Sumino
authors.forename: Keinosuke
authors.initials: K
authors.lastname: Ryu
authors.forename: Gen
authors.initials: G
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Tokuhashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D011134:Polysaccharides / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D011134:Polysaccharides; D000077425:Fondaparinux