Complications of perioperative warfarin therapy in total knee arthroplasty

Simpson, Phil M.S., Brew, Chris J., Whitehouse, Sarah L., Crawford, Ross W., & Donnelly, Bill J. (2014) Complications of perioperative warfarin therapy in total knee arthroplasty. The Journal of Arthroplasty, 29(2), pp. 320-324.

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Patients presenting for knee replacement on warfarin for medical reasons often require higher levels of anticoagulation peri-operatively than primary thromboprophylaxis and may require bridging therapy with heparin. We performed a retrospective case control study on 149 consecutive primary knee arthroplasty patients to investigate whether anti-coagulation affected short-term outcomes.

Specific outcome measures indicated significant increases in prolonged wound drainage (26.8% of cases vs 7.3% of controls, p<0.001); superficial infection (16.8% vs 3.3%, p<0.001); deep infection (6.0% vs 0%, p<0.001); return-to-theatre for washout (4.7% vs 0.7%, p=0.004); and revision (4.7% vs 0.3%, p=0.001).

Management of patients on long-term warfarin therapy following TKR is particularly challenging, as the surgeon must balance risk of thromboembolism against post-operative complications on an individual patient basis in order to optimise outcomes.

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ID Code: 63932
Item Type: Journal Article
Refereed: Yes
Keywords: total knee arthroplasty, anticoagulation, warfarin, bridging, heparin, complications
DOI: 10.1016/j.arth.2012.11.003
ISSN: 0883-5403
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2014 Published by Elsevier Inc.
Copyright Statement: NOTICE: this is the author’s version of a work that was accepted for publication in The Journal of Arthroplasty. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Journal of Arthroplasty, [Volume 29, Issue 2, (February 2014)] DOI: 10.1016/j.arth.2012.11.003
Deposited On: 04 Nov 2013 22:42
Last Modified: 05 Mar 2015 10:25

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