Thromboembolic risk after knee endoprosthesis

Thromboembolic complications are the most frequent associated pathologies af- ter knee replacement. The secondary deep vein thrombosis in the knee arthroplasty is often low symptomatic or asymptomatic and, sometime, it could lead to fatal pulmonary embolism. This is the main purpose recommending an antithrom- botic prophylaxis. In this study 214 patients oper- ated for knee arthroplasty and receiving low mol- ecular heparin therapy were enrolled. They were clinically and echo/radiologically monitored for thromboembolic and/or hemorrhagic complica- tions on the 2 nd , 7 th , 14 th and 45 th day from surgery. Results showed that only 45% of the cases developed DVT (deep vein thrombosis) out of which 17% could be objectively verified by ul- trasonography and phlebography. In only one case massive pulmonary embolism with fatal evo- lution was discovered. It was not found any major bleeding except in four cases in which local haematomas were discovered (most probably re- lated to anticoagulant treatment). This study con- cluded that the administration of low molecular weight heparin after knee arthroplasty significant- ly reduces the risks of thromboembolism in con- ditions where the increase of hemorrhagic com- plications doesn't result statistically significant.