Preventing DVT following total knee replacement: a review of recent clinical trials

Deep vein thrombosis (DVT) following total hip or knee arthroplasty is a frequent complication which can cause fatal pulmonary embolism (PE). Although many different approaches to its prevention have been attempted, low-dose warfarin has become the standard treatment for the prevention of thromboembolic disease following total hip and knee arthroplasty. Although subcutaneous heparin can reduce the incidence of thromboembolic disease, it has been associated with excessive bleeding complications. The introduction of low molecular weight heparins promises fewer bleeding complications with efficacy equal to that of warfarin. We wish to report the results of a randomized, prospective study comparing a low molecular weight heparin with low dose warfarin in the prevention of thromboembolic disease following total knee arthroplasty (TKA).