ArticleJournal of orthopaedic surgery and research2015
Warfarin cessation is non-essential in patients undergoing total knee arthroplasty--a case-control study.
Article in Journal of orthopaedic surgery and research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Perioperative Management of Chronic Antithrombotic Agents in Elective Hip and Knee Arthroplasty.Medicina (Kaunas, Lithuania) · 2021Review
- Article
- Blood loss in primary total knee arthroplasty--body temperature is not a significant risk factor--a prospective, consecutive, observational cohort study.Journal of orthopaedic surgery and research · 2015Observational
- Interruption of long-term warfarin is not necessary in patients undergoing total hip arthroplasty.Journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWarfarinised patients frequently present for total knee arthroplasty (TKA). Current practice of heparin 'bridging' is potentially cumbersome and hazardous. The research question is if cessation of warfarin is necessary for TKA.
methodsThe study design was a retrospective case-control series of 61 warfarinised patients and 61 control patients undergoing TKA. TKA was performed by the senior author using a medial parapatellar approach without tourniquet. The target perioperative international normalised ratio (INR) for warfarinised patients was 2-2.2. Primary outcomes were changes in haemoglobin, transfusion requirements and complication rates.
resultsThere was no statistically significant difference between control and warfarin group in mean perioperative Hb (g/L) (pre-op 140 vs 141, day 0 115 vs 115, day 1 108 vs 111, P = 0.63), transfusion rates (14.75% vs 9.83%, P = 0.58), total complication rate (9.8% vs 9.8%, P = 0.75), demographics, range of motion or length of stay. There was a statistically significant higher use of the re-infusion drain in the warfarinised group (47.5% vs 24.6%, P = 0.014).
conclusionThis study supports the hypothesis that warfarin cessation is non-essential in patients undergoing TKA. This data is applicable to a patient group using re-infusion drains. Limitations of this study are typical of a small non-controlled observational study.
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