Enoxaparin versus No Anticoagulation Prophylaxis after Total Knee Arthroplasty in Thai Patients: A Randomized Controlled Trial.

BACKGROUND:

There has been some controversy about routine use of thromboprophylaxis after total knee arthroplasty (TKA) in Asian patients.

OBJECTIVE:

To compare the efficacy and safety of enoxaparin in preventing venous thromboembolic diseases after TKA in Asian patients.

MATERIAL AND METHOD:

We randomized 50 patients undergoing primary TKA into two equal groups, 25 patients received once daily subcutaneous enoxaparin injections as thromboprophylaxis and 25 control patients did not receive anticoagulation. The primary outcome was deep vein thrombosis (DVT) identified by color Doppler ultrasonography and/or pulmonary embolism (PE). All significant bleeding complications were recorded.

RESULTS:

Deep vein thrombosis occurred in only one patient in the control group (4%) and in none in the enoxaparin group (0%, p = 0.31). No patient in both groups had clinical signs of PE. No patient had significant bleeding complications. One patient in enoxaparin group had a minor bleeding complication (4%) and also a surgical wound complication.

CONCLUSION:

We concluded that the incidence of thromboembolic diseases after primary TKA in Thai patients is very low. Enoxaparin had no significant benefit in reducing venous thromboembolic complications after TKA in Asian patients, however it is safe in term of bleeding complications. We do not recommend routine use of enoxaparin as thromboprophylaxis after TKA in Asian patients.