ATTITUDES TO, AND UTILIZATION OF, LOW-MOLECULAR-WEIGHT HEPARINS IN JOINT REPLACEMENT SURGERY

A postal survey was carried out to determine the attitudes to the use of low molecular weight heparin (LMWH) in joint replacement among two representative groups of orthopaedic surgeons practising in the UK. 72 % of hip surgeons and 51% of knee surgeons replying had used LMWHs for deep vein thrombosis prophylaxis in joint replacement patients. Of th ese, 48% had discontinued LMWH use due to bleeding complications. Amon g those continuing to use LMWHs, 88% had witnessed excessive bruising around the wound and 53% had experienced increased wound bleeding or h aematomas. Although LMWHs have been shown to reduce post-operative thr omboembolism in these groups, clinical experience has revealed an incr eased incidence of bleeding complications associated with their use. T his has prevented their routine use in joint replacement, as was the c ase with unfractionated heparin in the past.