BACKGROUND: The optimum duration of prophylaxis against @entity1211 after total hip or knee replacement is uncertain. Our primary objective was to establish the efficacy of extended-duration prophylaxis on symptomatic venous @entity1031 . METHODS: We identified randomised trials comparing extended-duration prophylaxis using heparin or @entity1229 with placebo or untreated control in @entity1 undergoing elective total hip or knee replacement by searching electronic databases (MEDLINE, EMBASE), references from retrieved articles, and abstracts from conference proceedings, and by contact with pharmaceutical companies and investigators. Two reviewers independently extracted data on study design, symptomatic and symptomless @entity1211 , @entity204 , and @entity548 outcomes. Results from individual trials were combined with the Mantel-Haenszel method. FINDINGS: Nine studies met our inclusion criteria (3999 @entity1 ), eight with low molecular weight heparin, and one with unfractionated heparin. Extended-duration prophylaxis for 30-42 days significantly reduced the frequency of symptomatic @entity1211 (1.3% vs 3.3%, OR 0.38; 95% CI 0.24-0.61, numbers needed to treat [NNT]=50), with no statistical evidence of heterogeneity (x(2) test, p=0.69). There was a greater risk reduction in @entity1 undergoing hip replacement (1.4% vs 4.3%, 0.33; 0.19-0.56, 34) compared with knee replacement (1.0% vs 1.4%, 0.74; 0.26-2.15, 250). A significant reduction in symptomless venographic @entity1150 was also observed (9.6% vs 19.6%, 0.48; 0.36-0.63, 10). There was no increase in major @entity548 but extended-duration prophylaxis was associated with excess minor @entity548 (3.7% vs 2.5%, 1.56; 1.08-2.26, numbers needed to harm [NNH]=83). INTERPRETATION: Among @entity1 undergoing total hip or knee replacement, extended-duration prophylaxis significantly reduces the frequency of symptomatic @entity1211 . The reduction in risk is equivalent to about 20 symptomatic events per 1000 @entity1 treated.

Extended-duration prophylaxis against XXXX after total hip or knee replacement: a meta-analysis of the randomised trials.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity1150 :: ('MESH:D020246', 'Disease') :: ['deep vein thrombosis'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic events'] @entity1211 :: ('MESH:D054556', 'Disease') :: ['venous thromboembolism', 'venographic venous thromboembolism'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin']
@entity1211 :: (MESH:D054556,Disease) :: ['venous thromboembolism']
