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Prevention of post-discharge venous thromboembolism in patients with rheumatoid arthritis undergoing knee or hip arthroplasty: a continuing matter of debate
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Patients undergoing major hip or knee surgery are particularly
prone to postoperative venous thromboembolism (VTE)
that is, deep
venous thrombosis (DVT) and pulmonary embolism (PE). Without thromboprophylaxis, the incidence of DVT in such patients is more than
50%, and fatal PE occurs in 1-6%.1 These data are based on studies in which, predominantly, patients with osteoarthritis (OA)
were investigated.
It is not known whether or not there is a significant difference in the risk for developing VTE between patients with rheumatoid arthritis (RA) and those with OA undergoing major orthopaedic surgery as adequate investigations are lacking.2
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Thromboprophylaxis during hospitalisation |
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During the past three decades, numerous investigations documented the efficacy of unfractionated heparin, pneumatic compression, warfarin, and low molecular weight heparin (LMWH) in reducing the incidence of postoperative VTE.
Nowadays, LMWH is the most commonly applied thromboprophylactic agent
in most orthopaedic surgery units in Europe. The evidence for the
efficacy and safety of LMWH
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Immunology (including allergy)
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