A meta-analysis of thromboembolic prophylaxis in total knee arthroplasty
Deep venous thrombosis (DVT) is common in total knee arthroplasty (TKA). Because of the rarity of the most serious outcomes, most randomized controlled trials lack the power to analyze these outcomes. A meta-analysis was performed for agents used in DVT prophylaxis in TKA employing a Medline literat...
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| Published in | The Journal of arthroplasty Vol. 16; no. 3; pp. 293 - 300 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.04.2001
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Deep venous thrombosis (DVT) is common in total knee arthroplasty (TKA). Because of the rarity of the most serious outcomes, most randomized controlled trials lack the power to analyze these outcomes. A meta-analysis was performed for agents used in DVT prophylaxis in TKA employing a Medline literature search. Study inclusion criteria were randomized controlled trials comparing prophylactic agents in elective TKA with mandatory screening for DVT by venography. Fourteen studies (3,482 patients) met inclusion criteria. For total DVT, all agents except dextran and aspirin protected significantly better than placebo (P <.0001). For proximal DVT rates, low-molecular-weight heparin was significantly better than warfarin (P =.0002). There was a trend that aspirin was better than warfarin (P =.0106). No significant difference was found for symptomatic pulmonary embolism, fatal pulmonary embolism, major hemorrhage, or total mortality. |
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| AbstractList | Deep venous thrombosis (DVT) is common in total knee arthroplasty (TKA). Because of the rarity of the most serious outcomes, most randomized controlled trials lack the power to analyze these outcomes. A meta-analysis was performed for agents used in DVT prophylaxis in TKA employing a Medline literature search. Study inclusion criteria were randomized controlled trials comparing prophylactic agents in elective TKA with mandatory screening for DVT by venography. Fourteen studies (3,482 patients) met inclusion criteria. For total DVT, all agents except dextran and aspirin protected significantly better than placebo (P <.0001). For proximal DVT rates, low-molecular-weight heparin was significantly better than warfarin (P =.0002). There was a trend that aspirin was better than warfarin (P =.0106). No significant difference was found for symptomatic pulmonary embolism, fatal pulmonary embolism, major hemorrhage, or total mortality. Deep venous thrombosis (DVT) is common in total knee arthroplasty (TKA). Because of the rarity of the most serious outcomes, most randomized controlled trials lack the power to analyze these outcomes. A meta-analysis was performed for agents used in DVT prophylaxis in TKA employing a Medline literature search. Study inclusion criteria were randomized controlled trials comparing prophylactic agents in elective TKA with mandatory screening for DVT by venography. Fourteen studies (3,482 patients) met inclusion criteria. For total DVT, all agents except dextran and aspirin protected significantly better than placebo (P < .0001). For proximal DVT rates, low-molecular-weight heparin was significantly better than warfarin (P = .0002). There was a trend that aspirin was better than warfarin (P = .0106). No significant difference was found for symptomatic pulmonary embolism, fatal pulmonary embolism, major hemorrhage, or total mortality. |
| Author | Fitzgerald, R.H. Brookenthal, K.R. Freedman, K.B. Lonner, J.H. Lotke, P.A. |
| Author_xml | – sequence: 1 givenname: K.R. surname: Brookenthal fullname: Brookenthal, K.R. – sequence: 2 givenname: K.B. surname: Freedman fullname: Freedman, K.B. – sequence: 3 givenname: P.A. surname: Lotke fullname: Lotke, P.A. – sequence: 4 givenname: R.H. surname: Fitzgerald fullname: Fitzgerald, R.H. – sequence: 5 givenname: J.H. surname: Lonner fullname: Lonner, J.H. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/11307125$$D View this record in MEDLINE/PubMed |
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| Snippet | Deep venous thrombosis (DVT) is common in total knee arthroplasty (TKA). Because of the rarity of the most serious outcomes, most randomized controlled trials... |
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| SubjectTerms | Aged Arthroplasty, Replacement, Knee Aspirin - therapeutic use Female Heparin, Low-Molecular-Weight - therapeutic use Humans Male meta-analysis Postoperative Complications - prevention & control Randomized Controlled Trials as Topic thromboembolic disease total knee arthroplasty Venous Thrombosis - prevention & control Warfarin - therapeutic use |
| Title | A meta-analysis of thromboembolic prophylaxis in total knee arthroplasty |
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