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Effects of Anticoagulant Medication on Bone-Healing
Alexander J Butler1, Frank J Eismont
1Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, Florida.
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A substantial proportion of patients undergoing orthopaedic care are prescribed some form of anticoagulant medication, whether for perioperative venous thromboembolism prophylaxis or chronic anticoagulation in the setting of a cardiac or other condition.
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An abundance of preclinical data suggests that many commonly used anticoagulant medications may have a harmful effect on bone-healing.
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The orthopaedic surgeon should be informed and mindful of the added variable that anticoagulation may play in the outcomes of fracture treatment and bone-healing.
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Heparin and warfarin appear to have a greater detrimental impact than low-molecular-weight heparin. Factor Xa inhibitors may confer the least risk, with some studies even suggesting the potential for enhancement of bone-healing.
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