Long-term use of fondaparinux in major orthopedic surgery
Faik Altıntaş1, Çağatay Uluçay1, Ender Uğutmen2, Melih Güven2, Koray Ünay2
1Yeditepe Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul, Türkiye
2Göztepe Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye
Keywords: Arthroplasty; arthroplasty/replacement/hip; arthroplasty/ replacement/knee; fondaparinux; hip fractures; orthopedic surgery; orthopedics; venous thrombosis.
Objectives: This study aims to investigate whether the usage of fondaparinux sodium may result in major hemorrhages following major orthopedic surgery.
Patients and methods: Forty-three patients (30 females and 13 males; mean age 66 years; range 34 to 94 years) at the age of >18 years who were scheduled for major orthopedic surgery were included. Total hip arthroplasty, total knee arthroplasty and proximal femur fracture surgeries were defined as the major orthopedic surgeries. Prophylaxis was administered with 2.5 mg fondaparinux sodium once daily subcutaneously. Prophylaxis was initiated at 6-8 hours after the closure of incision. During the prophylaxis period (31±3 days), the patients were monitored for symptomatic deep venous thrombosis. Serum creatinine, platelet and hemoglobin levels were measured at the baseline and in the first week and at one month postoperatively. Wound healing time, healing complications, and major/minor hemorrhages seen during the prophylaxis period were recorded.
Results: During the follow-up, none of the patients had symptomatic deep vein thrombosis or symptomatic pulmonary embolism. Two patients (4.6%) had delayed wound healing, while four (9.3%) had minor ecchymosis. No major hemorrhages were observed in any patients.
Conclusion: With the long-term use of fondaparinux, we did not observe any major hemorrhagic complications. However, further large-scale studies including control groups are required to establish the effects of long-term use of fondaparinux.