Orthopädie und Muskulatur: Aktuelle Forschung
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Using Heparin Aspirin Protocol for Venous Thromboembolism Prevention in Knee or Hip Arthroplasty

Hassan Kassir*, Abolfazl Bagherifard, Kaveh Gharanizadeh, Mehdi Mohammadpour, Peyman Hahemi, Seyed Matin Sadat Kiaei

Background: There is much controversy about the appropriate method to prevent venous thromboembolism after Total Knee Arthroplasty or Total Hip Arthroplasty. Therefore, we designed this study to evaluate the results of using the heparin aspirin protocol to prevent deep vein thrombosis and pulmonary embolism in knee or hip arthroplasty patients from years 2019 to 2020 at Shafa Yahyaian Hospital.

Methods: We recruited patients who underwent Total Knee Arthroplasty or Total Hip Arthroplaty surgery at Shafa Yahyaian Hospital between years 2019 and 2020. Patients were enrolled in the census method after obtaining written consent.Demographic and clinical data were collected using a questionnaire or clinical file. Patients received 5000 units of Heparin per 12 hours for 5 days and after the patients received aspirin 80 mg tablets daily for one month. The duration of follow-up was 6 months after hospital discharge. Data were analyzed by SPSS 24 software. Significance level was set at 0.05. At all stages of the project implementation, the basic principles of the Helsinki Declaration (Ethics in Medical Research on Human) and the Ethics Committee of Iran University of Medical Sciences were observed.

Results: Of the 159 participants, 34 were males (21.4%) and 125 (78.6%) females. The mean age was 62.7 years with a standard deviation of 11.21 years. The mean body mass index was 28.59 kg/m2 with a standard deviation of 4.88. Sixteen (10.1%) reported smoking. 80 patients (50.31%) had hypertension. Mean platelet count before and 5 days after surgery was not significantly different between the two groups (p=0.327) and (p=0.160). Hyperextension in patients did not show significant changes before and 6 months after surgery. However, for the two knee flexion-contraction and knee flexion movements, these postoperative range of motion were significant (p=0.001) and (p=0.007) respectively.

Conclusion: The incidence of embolism in our study was 0.62% and the incidence of ecchymosis was 6.2%. It seems that the complication of using aspirin-heparin protocol in our study is less than similar studies in this regard.