Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 5, pp 679–683 | Cite as

Administration of enoxaparin 24 h after total knee arthroplasty: safer for bleeding and equally effective for deep venous thrombosis prevention

  • Fucun Liu
  • Xiaobing Chu
  • Jiefeng Huang
  • Kun Tian
  • Jiang Hua
  • Peijian TongEmail author
Knee Arthroplasty



The purpose of this study was to determine the safety and effectiveness, as assessed by risk of bleeding and incidence of deep venous thrombosis (DVT), of administering delayed low-molecular-weight heparin (LMWH) after total knee arthroplasty.


A prospective study of 210 consecutive patients undergoing primary unilateral total knee arthroplasty was undertaken. The patients were randomized into two groups: one of which was managed according to a standard LMWH program (LMWH-s group) and the other with delayed LMWH (LMWH-p). LMWH was initiated 12 h after wound closure in the LMWH-s group, and 24 h after wound closure in the LMWH-p group.


The total blood loss in the first three postoperative days was calculated and all complications were recorded. The mean total blood loss was 435 and 387 mL in the LMWH-s group and LMWH-p group, respectively (p < 0.01). No significant difference in the incidence of symptomatic DVT was observed. The mean length of hospital stay was 7.29 days in the LMWH-s group and 6.56 days in the LMWH-p group (p < 0.05).


After total knee arthroplasty, LMWH-p is safer for bleeding than LMWH-s and equally effective concerning prevention of DVT.


Deep venous thrombosis Low-molecular-weight heparin Medication Anticoagulation Total blood loss 



The authors received no grants or outside funding in support of their research or in the preparation of this manuscript. They did not receive payments or other benefits from, or have a commitment or agreement with, any commercial entity.

Conflict of interest

Each author certifies that he has no commercial associations that might pose a conflict of interest in connection with the submitted article.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Fucun Liu
    • 1
  • Xiaobing Chu
    • 1
  • Jiefeng Huang
    • 1
  • Kun Tian
    • 1
  • Jiang Hua
    • 1
  • Peijian Tong
    • 1
    Email author
  1. 1.Department of OrthopedicsThe First Affiliated Hospital of Zhejiang University of Traditional Chinese MedicineHangzhouChina

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