Administration of enoxaparin 24 h after total knee arthroplasty: safer for bleeding and equally effective for deep venous thrombosis prevention

210 patients undergoing primary total knee arthroplasty were randomized to administration of low-molecular-weight heparin (enoxaparin) started at either 12 hours or 24 hours after wound closure. The purpose of this study was to determine the effect of delayed LMWH administration (24h) on bleeding and the incidence of deep vein thrombosis after TKA compared to standard administration (12h). Over the first 72 postoperative hours, total blood loss was significantly lower in the delayed administration group, leading to a significantly lower incidence of transfusion and major bleeding events. There was no significant difference in the incidence of deep vein thrombosis observed between groups.