Woolson ST, Robinson RK, Khan NQ, Roqers BS, Maloney WJ.
Deep venous thrombosis prophylaxis for knee replacement:
warfarin and pneumatic compression.
Am J Orthop 1998 Apr;27(4):299-304

Stanford University, California, USA.

A prospective study of the prevalence of proximal deep venous thrombosis in total
knee replacement patients who had prophylaxis for thrombosis with a combination
of low-dose warfarin and intermittent pneumatic compression was done. Two hundred
and ninety-seven patients who underwent 377 consecutive total knee replacements
were studied. All patients were treated with low-dose warfarin and intermittent
pneumatic compression using thigh-high sleeves. Surveillance for proximal
thrombosis was done by duplex ultrasonography. Proximal thrombosis was detected
in 19 patients, for a prevalence of 5%. There were 3 patients who had a major
bleeding complication, for a prevalence of 0.9% for the 337 procedures performed.
Although there was no concurrent control group of patients treated with another
means of prophylaxis to compare with these patients, the low prevalence of
proximal thrombosis and the low risk of major bleeding complications that was
found compares well with recent reports on the effectiveness and safety of
low-molecular-weight heparin.