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Thromboembolic prophylaxis for total knee arthroplasty in Asian patients: a randomised controlled trial
1Adult Reconstructive Team, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. chinpl@singnet.com.sg
Purpose:
To compare the efficacy and safety of different modes of thromboembolic prophylaxis for elective total knee arthroplasty (TKA) in Asian patients.
Methods:
440 low-risk patients undergoing TKA were randomised into 4 equal groups: (1) no prophylaxis (control), (2) graduated compression stockings (GCS), (3) intermittent pneumatic compression (IPC), and (4) low-molecular-weight heparin (enoxaparin). Duplex ultrasonography was used as an assessment tool.
Results:
The deep vein thrombosis point prevalence was highest in the control group (22%), which was significantly higher than in patients receiving IPC (8%, p=0.032) or enoxaparin (6%, p=0.001). One patient each in the control and GCS groups developed a non-fatal pulmonary embolism. Patients on enoxaparin received more blood transfusions and 2 of them had major bleeding complications.
Conclusion:
IPC is the preferred method of thromboprophylaxis for TKA in Asian patients.
