Primary studies included in this systematic review

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EPCAT (Extended Prophylaxis Comparing Low Molecular Weight Heparin to Aspirin in Total Hip Arthroplasty)

This thread includes 3 references

Publication Thread

RE-NOVATE 2

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Primary study

Unclassified

Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin.

Journal The Journal of bone and joint surgery. American volume
Year 2010
Liens Pubmed DOI

Cet article est inclus dans 5 Systematic reviews Systematic reviews (5 references)

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BACKGROUND: Thromboembolic disease is a common complication of total hip arthroplasty. The purpose of this study was to compare a new mobile compression device with low-molecular-weight heparin with regard to their safety and effectiveness for the prevention of venous thromboembolic disease. METHODS: Patients who had a total hip arthroplasty were randomized to receive prophylaxis with a mobile compression device or low-molecular-weight heparin for ten days. Use of the compression device began intraoperatively, and the patients in this group could receive 81 mg of aspirin daily after the surgery. The first injection of the low-molecular-weight heparin began between twelve and twenty-four hours after the surgery. After ten to twelve days, all patients underwent bilateral lower-extremity duplex ultrasonography to screen for deep venous thrombi in the calf and thigh. Any clinical symptoms of pulmonary embolism were evaluated with spiral computed tomography lung scans. Bleeding events and utilization of (i.e., compliance with) prophylactic treatment in both groups were documented. Clinical evaluation to look for evidence of deep venous thrombi and pulmonary emboli was performed at twelve weeks postoperatively. RESULTS: Four hundred and ten patients (414 hips) were randomized; 392 of these patients (395 of the hips) were evaluable with regard to the safety of the intervention and 386 patients (389 hips) were evaluable with regard to its efficacy. Demographics were similar clinically between the groups. The rate of major bleeding events was 0% in the compression group and 6% in the low-molecular-weight heparin group. The rates of distal and proximal deep venous thrombosis were 3% and 2%, respectively, in the compression group compared with 3% and 1% in the heparin group. The rates of pulmonary embolism were 1% in the compression group and 1% in the heparin group, and there were no fatal pulmonary emboli. Within the twelve-week follow-up period, two events (one deep venous thrombosis and one pulmonary embolus) occurred in one patient in the compression group following negative findings on duplex ultrasonography on the twelfth postoperative day. There was no difference between the groups with regard to the prevalence of venous thromboembolism. CONCLUSIONS: When compared with low-molecular-weight heparin, use of the mobile compression device for prophylaxis against venous thromboembolic events following total hip arthroplasty resulted in a significant decrease in major bleeding events.

Publication Thread

ADVANCE-3 (Apixaban for the Prevention of Thrombosis-related Events - 3)

This thread includes 6 references

Publication Thread

RECORD 1 (REgulation of Coagulation in ORthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism 1)

This thread includes 11 references

Publication Thread

RECORD 2 (Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism 2)

This thread includes 7 references

Publication Thread

RE-NOVATE

This thread includes 4 references

Publication Thread

Eriksson et al [provisional name]

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Publication Thread

Study 11527

This thread includes 2 references

Primary study

Unclassified

Flexibility in administration of fondaparinux for prevention of symptomatic venous thromboembolism in orthopaedic surgery.

Journal The Journal of arthroplasty
Year 2006
Liens Pubmed DOI

Cet article est inclus dans 1 Systematic review Systematic reviews (1 reference)

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Venous thromboembolism (VTE) is a common complication of total joint arthroplasty. Fondaparinux VTE prophylaxis is currently begun 6 to 8 hours after surgery. Flexible dosing may reduce bleeding risk and allow easier use by starting the morning after surgery instead of staggered hours on the surgery day. This study examined flexible timing of the first dose of fondaparinux. Whether the first dose was administered 8 +/- 2 hours after surgery or the morning after surgery, no significant difference was observed in incidence of symptomatic VTE (2.0% and 1.9%, respectively, P = .89). Major and minor bleeding events were similar between groups (1.2% and 0.7% [P = .19], and 1.4% and 2.0% [P = .31], respectively). Delaying initiation of fondaparinux prophylaxis provides an option after total joint arthroplasty with preserved efficacy and safety.