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Transfusions required after TKA in patients with warfarin bridged with LMWH

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Bleeding and other complications after total knee arthroplasty are of concern to patients and their surgeons, and both can be challenging to control.

However, results of a recently published study discussed in an Orthopaedics Today Europe article showed that when investigators applied the latest American College of Chest Physician guidelines, total knee arthroplasty (TKA) patients who had warfarin bridged with low-molecular-weight heparin (LMWH) had a 42% rate of complications, compared with a 7% rate in a matched cohort of patients who underwent TKA but were not on warfarin.

Twenty-one percent of patients in the study group required an additional procedure within 90 days of undergoing TKA, such as surgical evacuation of hematoma.

“Thereby, surgeons should be aware of the risk of complications in the early postoperative course in this high-risk population and provide this information to the patient prior to the surgical procedure,” Moussa Hamadouche, MD, PhD, of Paris, told Orthopaedics Today Europe.