Is Low-Molecular-Weight Heparin Suitable in All Patients Undergoing Knee Arthroplasty?

Letters4 November 2008Is Low-Molecular-Weight Heparin Suitable in All Patients Undergoing Knee Arthroplasty?Giuseppe Camporese, MD, Franco Noventa, MD, and Enrico Bernardi, MD, PhDGiuseppe Camporese, MDFrom the University Hospital of Padua, 35128 Padua, Italy, and Hospital of Conegliano Veneto, 31015 Conegliano, Italy.Search for more papers by this author, Franco Noventa, MDFrom the University Hospital of Padua, 35128 Padua, Italy, and Hospital of Conegliano Veneto, 31015 Conegliano, Italy.Search for more papers by this author, and Enrico Bernardi, MD, PhDFrom the University Hospital of Padua, 35128 Padua, Italy, and Hospital of Conegliano Veneto, 31015 Conegliano, Italy.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-9-200811040-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Geerts' evaluation of our work. We are aware that our conclusions differ from the 8th ACCP guidelines about the prevention of VTE after knee arthroscopy (1). We also note that Table 9 in those guidelines incorrectly lists the incidence of VTE found in our trial: The table's numbers for our trial differ from those presented at the last International Society of Thrombosis and Haemostasis Congress and from those presented in our article. We offer the following responses to the other points made by Dr. Geerts.First, we agree that the accuracy of ultrasonography in the ...References1. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR; American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:381S-453S. PMID: 18574271 CrossrefMedlineGoogle Scholar2. Kearon C, Julian JA, Newman TE, Ginsberg JS. Noninvasive diagnosis of deep venous thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med. 1998;128:663-77. PMID: 9537941 LinkGoogle Scholar3. Wirth T, Schneider B, Misselwitz F, Lomb M, Tyl H, Egbring R; Prevention of venous thromboembolism after knee arthroscopy with low-molecular weight heparin (reviparin): Results of a randomized controlled trial. Arthroscopy. 2001;17:393-9. PMID: 11288011 CrossrefMedlineGoogle Scholar4. Michot M, Conen D, Holtz D, Erni D, Zumstein MD, Ruflin GB; Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery: A randomized trial of prophylaxis with lowmolecular weight heparin. Arthroscopy. 2002;18:257-63. PMID: 11877611 CrossrefMedlineGoogle Scholar5. Lassen MR, Ageno W, Borris LC, Lieberman JR, Rosencher N, Bandel TJ; RECORD3 Investigators. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358:2776-86. PMID: 18579812 CrossrefMedlineGoogle Scholar6. Lapidus L, de Bri E, Ponzer S, Elvin A, Norn A, Rosfors S. High sensitivity with color duplex sonography in thrombosis screening after ankle fracture surgery. J Thromb Haemost. 2006;4:807-12. PMID: 16634750 CrossrefMedlineGoogle Scholar7. Gray H. Gray's Anatomy. New York: Gramercy Books; 1918. Google Scholar8. Leizorovicz A, Kassai B, Becker F, Cucherat M. The assessment of deep vein thromboses for therapeutic trials. Angiology. 2003;54:19-24. PMID: 12593492 CrossrefMedlineGoogle Scholar9. Kassa B, Boissel JP, Cucherat M, Sonie S, Shah NR, Leizorovicz A. A systematic review of the accuracy of ultrasound in the diagnosis of deep venous thrombosis in asymptomatic patients. Thromb Haemost. 2004;91:655-66. PMID: 15045125 CrossrefMedlineGoogle Scholar10. Hull RD. Thromboprophylaxis in knee arthroscopy patients: revisiting values and preferences Editorial. Ann Intern Med. 2008;149:137-9. PMID: 18626053 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Giuseppe Camporese, MD; Franco Noventa, MD; Enrico Bernardi, MD, PhDAffiliations: From the University Hospital of Padua, 35128 Padua, Italy, and Hospital of Conegliano Veneto, 31015 Conegliano, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNoninvasive Diagnosis of Deep Venous Thrombosis Clive Kearon , Jim A. Julian , M Math , Toni E. Newman , and Jeffrey S. Ginsberg Low-Molecular-Weight Heparin versus Compression Stockings for Thromboprophylaxis after Knee Arthroscopy Giuseppe Camporese , Enrico Bernardi , Paolo Prandoni , Franco Noventa , Fabio Verlato , Paolo Simioni , Kadimashi Ntita , Giovanna Salmistraro , Christos Frangos , Franco Rossi , Rosamaria Cordova , Francesca Franz , Pietro Zucchetta , Dimitrios Kontothanassis , and Giuseppe Maria Andreozzi , for the KANT (Knee Arthroscopy Nadroparin Thromboprophylaxis) Study Group* Thromboprophylaxis in Knee Arthroscopy Patients: Revisiting Values and Preferences Russell D. Hull Is Low-Molecular-Weight Heparin Suitable in All Patients Undergoing Knee Arthroplasty? William Geerts Metrics Cited byPrevention of thrombosisCurrent World LiteratureCurrent awareness: Pharmacoepidemiology and drug safety 4 November 2008Volume 149, Issue 9Page: 687-688KeywordsHemorrhageKneesLow molecular weight heparinPulmonary embolismSafetySafety studiesSurgeryThrombosisUltrasound imagingVeins ePublished: 4 November 2008 Issue Published: 4 November 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...