Role of Low Molecular Weight Heparin in Thromboprophylaxis for Hip and Knee Arthroplasty Chaudhary Deepinder1, Singh Mahipat1,*, Bhathal Manrattan2, Baiswar Neha3, Randhawa Jayant4, Randhawa Divyant5 1Joint Replacement and Reconstruction Unit, Sir Ganga Ram Hospital, New Delhi 2Consultant, Department of Anaesthesia, B L Kapoor Hospital, New Delhi 3DNB Obstetrics and Gynaecology, Sanjay Gandhi Memorial Hospital, New Delhi 4B. Sc. Health Sciences, Trent University, Peterborough, ON, Canada 5Master of Medicine, National Pirogov Memorial Medical University, Vinnystya (Ukraine) *Corresponding author: Mahipat Singh, Clinical Fellow, Joint Replacement and Reconstruction Unit, Sir Ganga Ram Hospital, New Delhi. Email: mahipatsingh2511@gmail.com
Online published on 6 April, 2019. Abstract A prospective double blind study was conducted in 200 patients for the duration of one year with the aim to study the role of low molecular weight heparin (LMWH) for deep vein thrombosis (DVT) prophylaxis in hip and knee arthroplasty patients. Routine bilateral limb venography was employed to detect the presence or absence of the thrombus in patients at the time of admission and till 12 weeks post operatively. Thrombi were detected in 40% of the patients of the control group who did not receive any prophylaxis during the post operative follow up period whereas 50% reduction of DVT was noted in patients who received LMWH prophylaxis. In this study highest incidence of DVT was seen in Bipolar hip hemi-arthroplasty (50% reduction) and those who underwent revision knee replacement surgeries (71.4%). Lower bleeding rate of 3% in this study has been attributed to intrinsic property of LMWH. Thrombi were detected in 30% to 40% of patient form 2nd post op week onwards uptill 4th post op week, making it imperative for extended and outpatient LMWH prophylaxis. LMWH contains in its chemical structure a unique pentasaccharide that is required for specific binding to Anti thrombin lll (AT lll). Their ability to catalyze the inhibition of factor Xa by AT lll makes them potent antithrombotic agent used for DVT prophylaxis. Top Keywords Deep Vein Thrombosis (DVT), Hip Replacement Arthroplasty (HRA), Knee Replacement Arthroplasty (KRA). Top |