Comparison of efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism in lower extremities after total hip arthroplasty and total knee arthroplasty: a retrospective study of 592 patients

BMC Surg. 2024 May 18;24(1):162. doi: 10.1186/s12893-024-02440-0.

Abstract

Objectives: To compare the efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism (DVT) in lower extremities after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: A total of 592 patients were enrolled in the study. Clinical data of patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in our hospital from December 2021 to September 2022 were retrospectively collected, which mainly included patients' general information, surgery-related information, and DVT-related information. The patients were categorized into the nadroparin group(n = 278) and the fondaparinux sodium group(n = 314) according to the types of anticoagulants used. Anticoagulant therapy began 12-24 h after operation and continued until discharge. DVT prevalence between two groups was compared. The Statistical Package for Social Sciences (SPSS) software version 25 (SPSS, Armonk, NY, USA) was used for statistical analysis.

Results: The prevalence of DVT in the nadroparin group and the fondaparinux sodium group was 8.3% (23/278) and 15.0% (47/314), respectively(p = 0.012). Statistical analysis showed that nadroparin group showed a lower prevalence of thrombosis than fondaparinux group (OR = 1.952, P = 0.012). Subgroup analyses showed that nadroparin group had a lower prevalence of DVT than fondaparinux group in some special patients groups such as female patients (OR = 2.258, P = 0.007), patients who are 65-79 years old (OR = 2.796, P = 0.004), patients with hypertension (OR = 2.237, P = 0.042), patients who underwent TKA (OR = 2.091, P = 0.011), and patients who underwent combined spinal-epidural anesthesia (OR = 2.490, P = 0.003) (P < 0.05).

Conclusion: Nadroparin may have an advantage over fondaparinux sodium in preventing DVT in lower extremities after THA and TKA.

Keywords: Deep vein Thromboembolism; Fondaparinux Sodium; Nadroparin; Total hip arthroplasty; Total knee arthroplasty.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anticoagulants* / administration & dosage
  • Anticoagulants* / therapeutic use
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Female
  • Fondaparinux* / therapeutic use
  • Humans
  • Lower Extremity / blood supply
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Nadroparin* / administration & dosage
  • Nadroparin* / therapeutic use
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Postoperative Complications* / prevention & control
  • Retrospective Studies
  • Treatment Outcome
  • Venous Thromboembolism* / epidemiology
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control