title: Administration of enoxaparin 24 h after total knee arthroplasty: safer for bleeding and equally effective for deep venous thrombosis prevention.
abstract: BACKGROUND
  The purpose of this study was to determine the safety and effectiveness, as assessed by risk of bleeding and incidence of deep venous thrombosis (DVT), of administering delayed low-molecular-weight heparin (LMWH) after total knee arthroplasty.
  
  
  METHODS
  A prospective study of 210 consecutive patients undergoing primary unilateral total knee arthroplasty was undertaken. The patients were randomized into two groups: one of which was managed according to a standard LMWH program (LMWH-s group) and the other with delayed LMWH (LMWH-p). LMWH was initiated 12 h after wound closure in the LMWH-s group, and 24 h after wound closure in the LMWH-p group.
  
  
  RESULTS
  The total blood loss in the first three postoperative days was calculated and all complications were recorded. The mean total blood loss was 435 and 387 mL in the LMWH-s group and LMWH-p group, respectively (p < 0.01). No significant difference in the incidence of symptomatic DVT was observed. The mean length of hospital stay was 7.29 days in the LMWH-s group and 6.56 days in the LMWH-p group (p < 0.05).
  
  
  CONCLUSIONS
  After total knee arthroplasty, LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, 54 Youdian Road, Shangcheng District, Hangzhou, 310006, China.
authors.forename: Fucun
authors.initials: F
authors.lastname: Liu
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Chu
authors.forename: Jiefeng
authors.initials: J
authors.lastname: Huang
authors.forename: Kun
authors.initials: K
authors.lastname: Tian
authors.forename: Jiang
authors.initials: J
authors.lastname: Hua
authors.forename: Peijian
authors.initials: P
authors.lastname: Tong
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D017984:Enoxaparin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin