Low molecular weight heparin for the prevention of deep venous thrombosis after total knee arthroplasty: A systematic review and meta-analysis. (June 2018)

• Record Type: Journal Article
• Authors: Xia, Ze-Nan; Zhou, Qing; Zhu, Wei; Weng, Xi-Sheng
• Is Part Of: International journal of surgery. Volume 54(2018)Part A
• Page Start: 265
• Page End: 275
• Publication Date: 2018-06
• Subjects: Low-molecular-weight heparin -- Deep venous thrombosis -- Total knee arthroplasty -- Meta-analysis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.04.059
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: To systematically evaluate the prophylaxis efficacy of low-molecular-weight heparin (LMWH) in the prevention of deep venous thrombosis (DVT) after total knee arthroplasty (TKA). Method: PubMed, Cochrane, Embase, Wanfang, CNKI, and VIP databases were searched by index words to identify the eligible RCTs; relevant literature sources were also searched. The latest research was conducted in March 2017. Relative risks (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs) were used to analyze the main outcomes. Result: A total of 22 articles were included in the meta-analysis with a total number of 11, 320 patients (5543 in the LMWH group and 5777 in the control group). The results indicated that in the LMWH group, the incidence of DVT (OR: 0.57, 95% CI: 0.41–0.77) and wound complications (SMD: 0.96, 95% CI: 0.75–1.22) was significantly lower than that in the control group. Furthermore, LMWH also increased the occurrence of bleeding event (OR: 1.57, 95% CI: 1.31–1.88) and the total blood transfused (SMD: 0.12, 95% CI: 0.04–0.19). However, no statistical difference was found in blood loss (SMD: −0.26, 95% CI: −0.65–0.14) between the two group. In the subgroup analysis, the incidence of DVT was significantly decreased in the ardeparin sodium group (OR: 0.70, 95%CI: 0.53–0.94) and the dalteparin group (OR:0.40, 95%CI:0.32–0.50). Conclusion: Our meta-analysis demonstrated that LMWH is obviously efficacious in the prophylaxis of DVT after TKA. However, it has some negative effects, such as the increase in the number of bleeding events and the total blood transfused. Highlights: The aim was to evaluate the prophylaxis efficacy of LMWH in the prevention of DVT after TKA. Total of 22 articles were included in the meta-analysis with a total number of 11, 320 patients. LMWH is obviously efficacious in the prophylaxis of DVT after TKA.