The Prophylaxis of Venous Thromboembolism in Korean Patients with Total Knee Replacement Arthroplasty.
10.4055/jkoa.2012.47.2.86
- Author:
Jin Kyu LEE
1
;
Kyu Sung CHUNG
;
Seung Wook BAEK
;
Choong Hyeok CHOI
Author Information
1. Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Korea. chhchoi@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
arthroplasty, replacement, knee;
venous thromboembolism;
deep vein thrombosis;
pulmonary embolism;
bleeding
- MeSH:
Arthroplasty;
Arthroplasty, Replacement, Knee;
Aspirin;
Dalteparin;
Hemorrhage;
Humans;
Incidence;
Knee;
Knee Joint;
Pulmonary Embolism;
Thigh;
Venous Thromboembolism;
Venous Thrombosis
- From:The Journal of the Korean Orthopaedic Association
2012;47(2):86-95
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the effects and problems of venous thromboembolism (VTE) prophylaxis with a reduced dosage and administration period in Korean total knee arthroplasty (TKA) patients. MATERIALS AND METHODS: We analyzed 135 consecutive TKA patients with three different VTE prophylaxis regimens. Group dalteparin-aspirin (DA) injected dalteparin for the first 2 days, followed by taking aspirin for the next 5 days, Group aspirin (A) was on aspirin and Group dalteparin (D) on dalteparin 7 days postoperatively. We evaluated the incidence of VTE and safety among the 3 groups. RESULTS: Symptomatic deep vein thrombosis was detected in 4 cases (Group DA: 2, Group A: 1, Group D: 1). Pulmonary embolism (PE) was found in 1 case in each group with no fatal PE. Although no major bleeding complications were seen, minor bleeding incidents were detected in 14 cases (Group DA: 2, Group A: 1, Group D: 11), which was significant in Group D. No significant differences were observed in perioperative blood loss, effusion in the knee joint, thigh swelling or oozing on the wound area among the groups except thigh bruising, which developed more frequently in group D. CONCLUSION: The reduced dosage and administration period of VTE prophylactic medicine combined with mechanical prophylaxis for Korean TKA patients showed no fatal PE, but some minor bleeding incidents frequently developed with 7 days of dalteparin injections. We need to adjust the dosage and duration of prophylactic medication deliberately for Korean TKA patients, considering prophylaxis effectiveness and bleeding complication risks.
