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Deep venous thrombosis prophylaxis for knee replacement: warfarin and pneumatic compression
S T Woolson1, R K Robinson, N Q Khan
1Stanford University, California, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|May 20, 1998
Summary
This study found that combining low-dose warfarin and intermittent pneumatic compression for deep venous thrombosis prophylaxis after total knee replacement resulted in a 5% prevalence of proximal thrombosis and a 0.9% major bleeding complication rate.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Thromboprophylaxis
Background:
- Deep venous thrombosis (DVT) is a significant risk following total knee replacement (TKR).
- Effective thromboprophylaxis is crucial to minimize DVT and pulmonary embolism risks in TKR patients.
Purpose of the Study:
- To determine the prevalence of proximal deep venous thrombosis (DVT) in patients undergoing total knee replacement (TKR).
- To evaluate the safety and efficacy of a prophylaxis regimen combining low-dose warfarin and intermittent pneumatic compression (IPC).
Main Methods:
- A prospective study involving 297 patients undergoing 377 consecutive TKRs.
- All patients received low-dose warfarin and thigh-high intermittent pneumatic compression sleeves.
- Proximal DVT surveillance was conducted using duplex ultrasonography.
Main Results:
- Proximal DVT was detected in 19 patients, yielding a prevalence of 5%.
- Three patients experienced major bleeding complications, resulting in a 0.9% complication rate across 337 procedures.
Conclusions:
- The combination of low-dose warfarin and IPC demonstrates a low prevalence of proximal DVT after TKR.
- This prophylaxis regimen appears to offer a favorable safety profile with a low risk of major bleeding complications, comparable to low-molecular-weight heparin.