• Fucun Liu, Xiaobing Chu, Jiefeng Huang, Kun Tian, Jiang Hua, and Peijian Tong.
• Department of Orthopedics, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, 54 Youdian Road, Shangcheng District, Hangzhou, 310006, China.
• Arch Orthop Trauma Surg. 2014 May 1; 134 (5): 679-83.

BackgroundThe purpose of this study was to determine the safety and effectiveness, as assessed by risk of bleeding and incidence of deep venous thrombosis (DVT), of administering delayed low-molecular-weight heparin (LMWH) after total knee arthroplasty.MethodsA prospective study of 210 consecutive patients undergoing primary unilateral total knee arthroplasty was undertaken. The patients were randomized into two groups: one of which was managed according to a standard LMWH program (LMWH-s group) and the other with delayed LMWH (LMWH-p). LMWH was initiated 12 h after wound closure in the LMWH-s group, and 24 h after wound closure in the LMWH-p group.ResultsThe total blood loss in the first three postoperative days was calculated and all complications were recorded. The mean total blood loss was 435 and 387 mL in the LMWH-s group and LMWH-p group, respectively (p < 0.01). No significant difference in the incidence of symptomatic DVT was observed. The mean length of hospital stay was 7.29 days in the LMWH-s group and 6.56 days in the LMWH-p group (p < 0.05).ConclusionsAfter total knee arthroplasty, LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT.

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