Prophylaxis of DVT with enoxaparin in patients undergoing total knee replacement

To evaluate the efficacy and safety of the low molecular weight heparin as prophylaxis against thromboembolism following total knee replacement surgery.

Post-operative bilateral lower extremity colour duplex scan was performed on 55 patients subjected to total knew arthroplasty. The scan was performed 7 days after surgery for detection of DVT. All patients were given Enoxaparin 40mg subcutaneous daily for 2 weeks as prophylaxis against DVT.

Two patients were diagnosed as DVT by color duplex scanning and both were distal but only one was asymptomatic. Another patient developed pulmonary embolism and died subsequently. The major and minor wound problems were seen in two and six patients respectively; nearly all complications were seen in obese patients.

DVT is not a nonexistent entity in our population. Low molecular weight heparins are safe drugs but apparently the bleeding complications are more as compared to Western literature. Larger case control studies are required to determine the true efficacy and safety of LMWH.