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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 1/2010

01-01-2010 | Symposium: Papers Presented at the Annual Meetings of the Knee Society

High Incidence of Complications From Enoxaparin Treatment After Arthroplasty

Authors: Andrew S. Neviaser, MD, Charles Chang, MD, Stephen Lyman, PhD, Alejandro Gonzales Della Valle, MD, Steven B. Haas, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2010

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Abstract

Pulmonary embolism (PE) complicates 1% to 10% of total joint arthroplasties and generally requires immediate anticoagulation. Low-molecular-weight heparins have supplanted unfractionated heparin as the treatment of choice for PE and hold a 1A recommendation from the American College of Chest Physicians for this indication. However, the complications of enoxaparin treatment begun in close proximity to arthroplasty surgery are not well described. We examined the records of 135 patients who underwent total joint arthroplasty, experienced an in-hospital PE, and received treatment with enoxaparin at therapeutic doses (1 mg/kg body weight). The type and frequency of complications were determined and classified as major or minor. Twenty-seven percent of patients experienced minor complications and 10% experienced major complications. The incidence of major bleeding was substantially higher than rates reported for nonsurgical patients. The overall complication rate of enoxaparin treatment is similar to the rate of complications reported for unfractionated heparin treatment in this setting, but the complications are less severe.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
High Incidence of Complications From Enoxaparin Treatment After Arthroplasty
Authors
Andrew S. Neviaser, MD
Charles Chang, MD
Stephen Lyman, PhD
Alejandro Gonzales Della Valle, MD
Steven B. Haas, MD
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 1/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1020-6

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