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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Thromboembolic and bleeding complications following primary total knee arthroplasty: a Danish nationwide cohort study

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  1. Ten-year follow-up of stemmed hemiarthroplasty for acute proximal humeral fractures

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  2. Is tranexamic acid use in patients with a hip fracture safe?

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  3. A comparison of conventional and minimally invasive multilevel surgery for children with diplegic cerebral palsy

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  1. Temporal trends in utilization of transcatheter aortic valve replacement and patient characteristics: a nationwide study

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  2. Diabetes increases the risk of bone fractures in patients on kidney replacement therapy: A DANISH national cohort study

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  3. Collection and Reporting of Patient-reported Outcome Measures in Arthroplasty Registries: Multinational Survey and Recommendations

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  4. No increase in postoperative contacts with the healthcare system following outpatient total hip and knee arthroplasty

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AIMS: The aim of this study is to compare the effectiveness and safety of thromboprophylactic treatments in patients undergoing primary total knee arthroplasty (TKA).

METHODS: Using nationwide medical registries, we identified patients with a primary TKA performed in Denmark between 1 January 2013 and 31 December 2018 who received thromboprophylactic treatment. We examined the 90-day risk of venous thromboembolism (VTE), major bleeding, and all-cause mortality following surgery. We used a Cox regression model to compute hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome, pairwise comparing treatment with dalteparin or dabigatran with rivaroxaban as the reference. The HRs were both computed using a multivariable and a propensity score matched analysis.

RESULTS: We identified 27,736 primary TKA patients who received thromboprophylactic treatment (rivaroxaban (n = 18,846); dalteparin (n = 5,767); dabigatran (n = 1,443); tinzaparin (n = 1,372); and enoxaparin (n = 308)). In the adjusted multivariable analysis and compared with rivaroxaban, treatment with dalteparin (HR 0.68 (95% CI 0.49 to 0.92)) or dabigatran (HR 0.31 (95% CI 0.13 to 0.70)) was associated with a decreased risk of VTE. No statistically significant differences were observed for major bleeding or all-cause mortality. The propensity score matched analysis yielded similar results.

CONCLUSION: Treatment with dalteparin or dabigatran was associated with a decreased 90-day risk of VTE following primary TKA surgery compared with treatment with rivaroxaban. Cite this article: Bone Joint J 2021;103-B(10):1571-1577.

Original languageEnglish
JournalThe bone & joint journal
Volume103-B
Issue number10
Pages (from-to)1571-1577
Number of pages7
ISSN2049-4394
DOIs
Publication statusPublished - Oct 2021

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Antithrombins/therapeutic use, Arthroplasty, Replacement, Knee/mortality, Dabigatran/therapeutic use, Dalteparin/therapeutic use, Denmark, Female, Fibrinolytic Agents/therapeutic use, Follow-Up Studies, Humans, Male, Middle Aged, Perioperative Care/adverse effects, Postoperative Complications/chemically induced, Postoperative Hemorrhage/chemically induced, Proportional Hazards Models, Registries, Rivaroxaban/therapeutic use, Tinzaparin/therapeutic use, Venous Thromboembolism/diagnosis, Young Adult

ID: 67995456