Low molecular weight heparin dosing regimens after total joint arthroplasty: a prospective, single-center, randomized, double-blind study

作者：Jingjing Shang, Liangliang Wang, Jinhong Gong, Xinru Liu, Dan Su, Xindie Zhou, Yuji Wang · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2024 · DOI：10.1186/s13018-024-05303-9 · 被引用次数：10 · 研究领域：Venous Thromboembolism Diagnosis and Management、Acute Myocardial Infarction Research、Heparin-Induced Thrombocytopenia and Thrombosis

BACKGROUND: Low molecular weight heparin (LMWH) has been the standard treatment for preventing venous thromboembolism after total joint arthroplasty. However, the evidence supporting specific LMWH dosing regimens is limited. OBJECTIVES: This study assessed the efficacy and safety of three enoxaparin dosing regimens to prevent venous thromboembolism. METHODS: Participants undergoing hip or knee replacement were randomly assigned to receive 20 mg of enoxaparin 6 h postoperatively (Group A), 40 mg 6 h postoperatively (Group B), or 40 mg 12 h postoperatively (Group C). The primary outcomes included thromboembolic and major bleeding events within 3 months, while the secondary outcomes comprised ecchymosis, wound exudation, drainage volume, allogeneic red blood cell transfusion, and first postoperative day hemoglobin levels. RESULTS: A total of 536 patients were analyzed. The occurrence of thromboembolic events was comparably low across all groups. Group C exhibited the lowest postoperative ecchymosis rate at 19.3%, significantly less than Group A (32.8%, p = 0.004) and Group B (37.7%, p < 0.001). Ecchymosis rates were about double in Group A and 1.5 times higher in Group B compared to Group C. Significant differences were also observed in 24-hour and total postoperative drainage volumes, with Group B having higher volumes than the other groups. CLINICAL TRIAL REGISTRATION: This trial was prospectively registered at the China Clinical Trials Registry (registration date: November 14...