Dutch orthopedic thromboprophylaxis: a 5-year follow-up survey

Figures & data

Table 1. Thromboprophylactic regimens used after elective arthroplasties (%)

	In hospital only		In hospital and extended thromboprophylaxis
Arthroplasty	LMWH		LMWH		LMWH and VKA's ^a		fondaparinux		Aspirin
	2002	2007	2002	2007	2002	2007	2002	2007	2002	2007
Total hip	2	None	17	79	80	7	NA	14	1	0
Revision hip	2	None	16	80	81	7	NA	13	1	0
Total knee	2	None	20	79	77	8	NA	14	1	0
Revision knee	2	None	18	80	79	7	NA	13	1	0
Hemi knee	9	3	8	78	82	7	NA	12	1	0
Average	3	1	17	79	79	7	NA	13	1	0

^a LMWH until adequate INR was reached; in 2002, 12% of departments used a coumarin only.

Table 2. Thromboprophylactic regimens used after fracture surgery. Values are percentages

	In hospital only		In hospital and extended out-of-hospital thromboprophylaxis
			LMWH		LMWH and VKA's ^a		fondaparinux
Trauma procedure	2002	2007	2002	2007	2002	2007	2002	2007
Hemi hip arthroplasty	9	3	15	78	75	9		10
Hip, internal fixation		1		81		9		9
Proximal femur, internal fixation		4		78		8		10
Proximal tibia, internal fixation		12		79		8		5

^a LMWH until adequate INR was reached.

Table 3. Thromboprophylactic regimens used after daycare surgery and knee arthroscopy (%)

	No prophylaxis		LMWH once or during admission		Other
Procedure	2002	2007	2002	2007	2002	2007
Day-care	40	64	59	34 ^a	0	2 ^c
Arthroscopy	40	4	59	49 ^b	1	3 ^d

^a 54% initiation preoperatively,

^b 52% initiation preoperatively,

^c 1 department used fondaparinux for 2 weeks and 1 LMWH for 5 days,

^d 1 department used LMWH for 5 days, 1 department recommended 6 weeks of vitamin K antagnist as prophylaxis and 1 department recommended 14 days of fondaparinux.

Table 4. Thromboprophylactic regimens used with immobilization of the lower extremity (%)

	No prophylaxis		LMWH		LMWH without weight bearing		fondaparinux		coumarin
Type of immobiliszation	2002	2007	2002	2007	2002	2007	2002	2007	2002	2007
Below the knee only	50	30	10	52	3	13	NA	4	37	1
Above the knee and ankle	11	6	16	84	5	5	NA	3	68	2