Why the study?
Many patients undergoing orthopaedic care receive anticoagulants, and preclinical data suggest these medications may adversely affect bone-healing.
Do anticoagulant medications affect bone-healing in patients undergoing orthopaedic care?
Do anticoagulant medications affect bone-healing in patients undergoing orthopaedic care?
Orthopaedic surgeons should be aware that different anticoagulants have varying impacts on bone-healing, with heparin and warfarin being more detrimental than LMWH or Factor Xa inhibitors.
Answers are grounded in this paper and cite their sources.
May inform anticoagulant selection in orthopaedic care; leaves open need for prospective trials before practice change.
»: A substantial proportion of patients undergoing orthopaedic care are prescribed some form of anticoagulant medication, whether for perioperative venous thromboembolism prophylaxis or chronic anticoagulation in the setting of a cardiac or other condition. »: An abundance of preclinical data suggests that many commonly used anticoagulant medications may have a harmful effect on bone-healing. »: The orthopaedic surgeon should be informed and mindful of the added variable that anticoagulation may play in the outcomes of fracture treatment and bone-healing. »: Heparin and warfarin appear to have a greater detrimental impact than low-molecular-weight heparin. Factor Xa inhibitors may confer the least risk, with some studies even suggesting the potential for enhancement of bone-healing.
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Butler et al. (2021) studied this question.
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