Adverse effects of antithrombotic therapy in joint replacements
Keywords:
Antithrombotic, Complication, Joint Replacement, Adverse EventAbstract
Introduction: Thromboembolic disease is the most common complication in total knee or hip replacement. Without prophylaxis, the incidence of thromboembolic disease in patients undergoing these surgeries increases up to 50%, and in 90% of patients with symptomatic pulmonary embolism the blood clots come from the legs.
Methods: We designed a case series with patients who underwent total hip or knee primary replacement at the Centro Médico Imbanaco, Cali, Colombia, between June 2009 and June 2010, and who were medicated with clexane or rivaroxaban as thromboprophylaxis in a scheme extended for 30 days.
Results: 251 patients were selected, of which 9 (3.6%) experienced adverse effects. The most frequent adverse effects were blistering and bruising of the operative site, with 4 patients. Two patients had surgical site infection, two had drug intolerance and one had fat necrosis of the operative site. We found 6 adverse events in patients taking clexane and 3 in patients receiving rivaroxaban. All patients with adverse events were obese.
Discussion: The percentage and type of adverse events was similar to that reported in the literature. It is important to design a study with a larger sample size and an appropriate design to establish risk factors for presentation of adverse events with the use of rivaroxaban or clexane as antithrombotic drugs.
Downloads
References
Colwell CW Jr, Froimson MI, Mont MA. Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin. J Bone Joint Surg Am 2010; 92: 527-35.
Gelfer Y, Tavor H, Oron A, Peer A, Halperin N, Robinson D. Deep vein thrombosis prevention in joint arthroplasties: continuous enhan¬ced circulation therapy vs. low molecular weight heparin. J Arthroplasty 2006; 21: 206-14.
White RH, Henderson MC. Risk factors for venous thromboembolism after total hip and knee replacement surgery. Curr Opin Pulm Med 2002; 8: 365-71.
Freedman KB, Brookenthal KR, Fitzgerald RH Jr, Williams S, Lonner JH. A meta- analysis of thromboembolic prophylaxis following elective total hip arthroplasty. J Bone Joint Surg Am 2000; 82: 929-38.
Pitto RP, Hamer H, Heiss-Dunlop W, Kuehle J. Mechanical prophylaxis of deep-vein thrombosis after total hip replacement. A randomised clinical trial. J Bone Joint Surg Br 2004; 86: 639-42.
Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: What are the implications for clinicians and pa¬tients? Chest 2009; 135: 513-20.
Colwell CW Jr, Spiro TE. Efficacy and safety of enoxaparin to prevent deep vein thrombosis after hip arthroplasty. Clin Orthop Relat Res 1995; 319: 215-22.
Johnson R, Carmichael JH, Almond HG, Loynes RP. Deep venous thrombosis following Charnley arthroplasty. Clin Orthop Relat Res 1978; 132: 24-30.
Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke. Chest 2008; 133: 630-69.
Perzborn E, Strassburger J, Wilmen A, Pohlmann J, Roehrig S, Schlem¬mer KH, et al. In vitro and in vivo studies of the novel antithrombotic agent BAY 59-7939. An oral, direct factor Xa inhibitor. J Thromb Haemost 2005; 3: 514-21.
Kubitza D, Becka M, Voith B, Zuehlsdorf M, Wen-Sing G. Safety, pharmacodynamics, and pharmacokinetics of the single doses of BAY 59-7939, an oral, direct factor Xa inhibitor. Clin Pharmacol Ther 2005; 78: 412-21.
Bailey JP, Kruger MP, Solano FX, Zajko AB, Rubash HE. Prospective randomized trial of sequential compression devices vs low-dose war¬farin for deep venous thrombosis prophylaxis in total hip arthroplasty. J Arthroplasty 1991; 6 Suppl: S29-35.
Cohen AT, Khushal A. Extended thromboprophylaxis following lower limb arthroplasty: what do the clinical trials mean? Haemostasis 2000; 30 Suppl 2: 88-94.
Gelfer Y, Tavor H, Oron A, Peer A, Halperin N, Robinson D. Deep vein thrombosis prevention in joint arthroplasties: continuous enhan¬ced circulation therapy vs low molecular weight heparin. J Arthroplasty 2006; 21: 206-14.
Turpie AG, Bauer KA, Eriksson BI, Lassen MR. PENTATHALON 2000 Study Steering Committee. Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip-replacement surgery: a randomised double-blind trial. Lancet 2002; 359: 1721-6. Erratum in: Lancet. 2002; 360: 1102.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sociedad Colombiana de Ortopedia y Traumatología
This work is licensed under a Creative Commons Attribution 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
