Efficacy and safety of enoxaparin in hip or knee joint replacement. A systematic review of the literature
DOI:
https://doi.org/10.1016/j.rccot.2016.01.001Keywords:
arthroplasty,replacement, hip, arthroplasty, replacement, knee, venous thrombosis, enoxaparin, systematic reviewAbstract
Introduction: Thromboprophylaxis is part of management protocols in joint replacement surgery, and enoxaparin is the most frequently used molecule. This literature review seeks to establish its efficacy and safety.
Materials and methods: A systematic review was performed on the literature of all randomized clinical trials of hip or knee replacement thromboprophylaxis that included enoxaparin as a comparator and evaluated the efficacy and safety in all the patients treated.
Results: Of a total of 199 references collected, 22 trials were included, with a total of 21,308 patients; 12 studies were on hip arthroplasty (12,738 patients, mean age 58.1, women 55.8%), and 10 knee arthroplasty (8,300 patients, mean age 66.2 years, women 64.8%). Mortality was 0.30 for hip replacement (95% CI: 0.2-0.4) and 0.17% (95% CI: 0.1-0.3) in knee. Symptomatic thromboembolism was present in 0.5 (95% CI: 0.4-0.7) and 1.0% (95% CI: 0.8-1.2) for hip and knee replacements, respectively, while major bleeding occurred in 0.75% (95% CI: 0.6-0.9), and 0.86% (95% CI: 0.7-1.1) of patients.
Discussion: Enoxaparin is a safe drug in joint replacement thromboprophylaxis. This work can serve as a basis for institutions that wish to develop surveillance programs in major orthopaedic surgery.
Evidence level: II.
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References
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