Key result
Postoperative fondaparinux alongside antiplatelet therapy shows ~1% minor bleeding and zero major bleeding or thrombosis.
Why the study?
Patients undergoing total hip or knee arthroplasty with antiplatelet therapy have a high risk for post-operative venous thromboembolism and require effective prophylaxis strategies.
Does post-operative fondaparinux prevent deep vein thrombosis and arterial thrombotic events in patients undergoing total hip or knee arthroplasty on pre-operative antiplatelet therapy?
Observational (n=556)
Open-label
No
Does post-operative fondaparinux prevent deep vein thrombosis and arterial thrombotic events in patients undergoing total hip or knee arthroplasty on pre-operative antiplatelet therapy?
Fondaparinux appears to be a safe and effective post-operative VTE prophylaxis strategy for patients undergoing major orthopedic surgery who are on pre-operative antiplatelet therapy.
Answers are grounded in this paper and cite their sources.
May support fondaparinux safety in this population; leaves open randomized confirmation of thrombosis prevention.
Patients undergoing total hip arthroplasty or total knee arthroplasty have a high risk for post-operative venous thromboembolism. The current study addressed the use of fondaparinux post-operatively in 556 patients with antiplatelet therapy in order to prevent deep vein thrombosis as well as demonstrate efficacy in preventing arterial thrombotic events. Results provided evidence for a safe and effective prophylaxis strategy, involving the change from low molecular weight heparin pre-operatively to fondaparinux postoperatively. Also, fondaparinux proved effective as a unique post-operative therapy in the prevention of venous thromboembolism with no adverse effects, such as major bleeding or arterial thrombosis in patients with pre-operative antiplatelet therapy.
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Grappiolo et al. (2013) conducted an observational in Total hip and knee arthroplasty in patients on antiplatelet therapy (n=556). Fondaparinux was evaluated on Incidence of major or minor bleeding. Fondaparinux prophylaxis in patients on antiplatelet therapy undergoing total hip or knee arthroplasty resulted in a 1.26% incidence of minor bleeding, with no major bleeding events or clinical vascular thrombosis observed.
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