• Der Unfallchirurg · Apr 2002

    Comparative Study Clinical Trial

    [Heparin-induced thrombocytopenia as a complication of postoperative prevention of thromboembolism with unfractionated heparin/low molecular weight heparin after hip and knee prosthesis implantation].

    • K Mahlfeld, J Franke, O Schaeper, R Kayser, and H Grasshoff.
    • Otto-von-Guericke-Universität Magdeburg, Orthopädische Universitätsklinik, Magdeburg.
    • Unfallchirurg. 2002 Apr 1; 105 (4): 327331327-31.

    AimWith this prospective study we analysed the occurrence of a heparin-induced thrombocytopenia type II (hit type II) using unfractioned heparin (UFH) or low-molecular-weight heparin (LMWH) as postoperative thrombosis prophylaxis after primary total hip or knee replacements. Furthermore the postoperative course of the platelet count with UFH and LMWH was investigated.Material And MethodsIn a prospective study we looked at the platelet count of 504 primary endoprothesis patients until the 9. postoperative day. 252 patients got UFH (3-mal 5000 IE Liquemin), 252 patients got LMWH (Clexane 40 opd) as thrombosis prophylaxis.Results5 patients of the UFH-group developed a HIT type II (incidence 2%; 95%-confidence interval 0.7-4.5) after 9.8 (7-16) days. Within the LMWH-group we saw just one case (incidence 0.4%; 95%-confidence interval 0-2.1). The drop of the platelet count was on average 64% (40.9-81.6). Within the 498 patients without a HIT type II just 2 patients had a drop of the platelet count between the 5. and 9. postoperative day of more than 15% referring to the preoperative value (24% and 33%).ConclusionThe incidence of a HIT type II after the use LMWH seems to be lesser than after the use of UFH. The postoperative platelet count shows a typical course after a total joint replacement. With deviations of that a HIT type II must be excluded.

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