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Sportverletz Sportschaden 2006; 20(3): 149-152
DOI: 10.1055/s-2006-927000
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Thromboseprophylaxe in der Knieendoprothetik

Stand der Therapie an deutschen orthopädisch-traumatologischen KlinikenPrevention of Deep Vein Thrombosis in Total Knee ReplacementCurrent Status of Therapy in Orthopedie and Trauma Departments in GermanyC. Lüring1 , F. Oczipka1 , H. Bäthis2 , J. Grifka1 , M. Tingart1
  • 1Orthopädische Klinik, Universität Regensburg (Direktor: Professor Dr. med. J. Grifka)
  • 2Abteilung für Unfallchirurgie und Orthopädie, Universität Witten-Herdecke (Direktor: Professor Dr. med. B. Bouillon)
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Publication History

Publication Date:
22 September 2006 (online)

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Zusammenfassung

Fragestellung: Die symptomatische tiefe Beinvenenthrombose ist mit einer Inzidenz von 4 - 5 % unter medikamentöser Thromboseprophylaxe eine ernsthafte Komplikation nach endoprothetischem Ersatz des Kniegelenks. Ziel dieser Arbeit ist die Erhebung aktuellen Prophylaxeverhaltens in der Knieendoprothetik an deutschen Kliniken. Material und Methode: In einer deutschlandweiten Umfrage wurden Fragebogen mit Items zur Thromboseprophylaxe in der Knieendoprothetik an 470 orthopädische und unfallchirurgische Kliniken versandt. Ergebnisse: 98 % der Kliniken führen eine Prophylaxe mit niedermolekularem Heparin, 2 % mit unfraktioniertem Heparin durch. Die niedermolekularen Heparine werden in 48 % der Kliniken in Standarddosierung, in 44 % gewichtsadaptiert appliziert. Erstgabe ist in 82 % der Kliniken der Abend vor der Operation. Im Mittel wird die TP für 4,7 Wochen durchgeführt. 96 % der Kliniken verwenden zusätzlich Antithrombosestrümpfe. Schlussfolgerung: Art und Umfang der TP bei endoprothetischem Kniegelenksersatz stimmen an der überwiegenden Zahl der befragten Kliniken mit den Leitlinienempfehlungen überein.

Abstract

Introduction: Symptomatic deep vein thrombosis is a serious complication after total knee arthroplasty, with a risk of about 4 - 5 % despite prevention with herparin. Aim of the current study was to find out about the actual status of thrombosis prophylaxis in Germany after total knee replacement. Material and Methods: In a countrywide survey 470 German trauma and orthopaedic surgery departments were asked about their prophylactic procedures addressing deep vein thrombosis after total knee replacement. Results: 98 % perform prevention of thrombosis with low-molecular-weight heparin, 2 % use unfractioned heparin. Low-molecular-weight heparin is applicated in standard doses in 48 % and in 44 % according to patient’s weight. In 82 % the prophylaxis is begun the night before surgery. The therapy is carried out for 4.7 weeks in mean. 96 % use graduated compressions stocking as additional therapeutic option. Conclusion: Our survey shows that most of the surgeons perform prevention of deep vein thrombosis according to the official guidelines.

Schlüsselwörter

Knieendoprothetik - Thromboseprophylaxe - tiefe Venenthrombose - nationale Umfrage

Key words

Total knee replacement - prevention of deep vein thrombosis - deep vein thrombosis - national survey

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Priv.-Doz. Dr. med. C. Lüring (zert. Gesundheitsökonom)

Orthopädische Klinik, Universität Regensburg

Kaiser-Karl-V.-Allee 3

93077 Regensburg

Email: c_luering@yahoo.de

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