Reitman RD, Emerson RH, Higgins LL, Tarbox TR.
A multimodality regimen for deep venous thrombosis prophylaxis in total knee
arthroplasty.
J Arthroplasty 2003 Mar;18(2):161-8

Texas Center For Joint Replacement, Plano, Texas 75093, USA.

Data indicate that deep venous thrombosis (DVT) occurs at the time of knee
arthroplasty. Nevertheless, literature concerning DVT prophylaxis has only recently
addressed this contention. This prospective study evaluated the efficacy of a
perioperative prophylactic regimen. Between January 1996 and June 2001, 1,308
knees (964 surgeries) underwent total knee arthroplasty. Patients were treated
routinely with intraoperative heparin (1000 units intravenous push before
inflation of the tourniquet and 500 units at deflation), hypotensive epidural
anesthesia (MAP 70-90), external pneumatic compression boots, and aspirin (325
mg, PO, BID for 6 weeks). Duplex venous ultrasonography was performed before
discharge. DVT was detected in 4% of cases (1% proximal and 3% distal). Bleeding
complications occurred in 1%, and perioperative medical complications occurred in
12%. Copyright 2003, Elsevier Science (USA). All rights reserved.