Ninety-day morbidity in patients undergoing primary TKA with discontinuation of warfarin and bridging with LMWH.
We asked whether patients under long-term warfarin and managed with current guidelines regarding bridging therapy have a higher complications rate within ninety days following total knee arthroplasty. We retrospectively identified 38 patients under long-term warfarin. They were match-paired with 76 control patients. Our results showed a significant increased rate of complications (42.1% vs. 6.9%, P < 0.001) and re-operation (21.1% vs. 5.2%, P < 0.001) in the warfarin group. The difference was related to the number of hematomas requiring surgical evacuation. The warfarin group had a significantly higher rate of blood loss, blood transfusion, and length of hospital stay. Our data suggest that current guidelines for preoperative warfarin management are associated with a high rate of bleeding complications and reoperations following TKA.
Department of Reconstructive and Orthopaedic Surgery, Clinical Orthopaedic Research Centre, Université Paris Descartes, Hôpital Cochin (AP-HP), Paris, France.
Emmanuel
E
Gibon
Department of Reconstructive and Orthopaedic Surgery, Clinical Orthopaedic Research Centre, Université Paris Descartes, Hôpital Cochin (AP-HP), Paris, France.
Nicolas
N
Barut
Department of Reconstructive and Orthopaedic Surgery, Clinical Orthopaedic Research Centre, Université Paris Descartes, Hôpital Cochin (AP-HP), Paris, France.
Phillipe
P
Anract
Department of Reconstructive and Orthopaedic Surgery, Clinical Orthopaedic Research Centre, Université Paris Descartes, Hôpital Cochin (AP-HP), Paris, France.
Jean-Pierre
JP
Courpied
Department of Reconstructive and Orthopaedic Surgery, Clinical Orthopaedic Research Centre, Université Paris Descartes, Hôpital Cochin (AP-HP), Paris, France.
Moussa
M
Hamadouche
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001803:Blood Transfusion; D015897:Comorbidity; D005260:Female; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D014859:Warfarin / Q000009:adverse effects
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin
TKA; bridging therapy; complications; re-operations; warfarin