Anticoagulant and anti-inflammatory effects of fondaparinux sodium during anterior cruciate ligament reconstruction in high risk VTE patients: A randomised controlled, triple blinded, prospective study.
Pai Zheng, Guangwei Che, Xueer Zhang et al.
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In 30 seconds
This single-centre, triple-blinded randomised controlled study compared fondaparinux with enoxaparin for 14 days after anterior cruciate ligament reconstruction in 72 patients at high risk of venous thromboembolism (Caprini score ≥5). No deep vein thrombosis or pulmonary embolism occurred in either group. Fondaparinux was associated with lower D-dimer and inflammatory-marker levels at multiple postoperative time points, longer thromboelastography reaction time, and less knee swelling on days 3 and 7. Pain, blood loss, and postoperative complications did not differ significantly between groups.
Key findings
- No deep vein thrombosis or pulmonary embolism was reported in either treatment group.
- Fondaparinux was associated with significantly lower D-dimer levels on postoperative days 3, 7, and 13.
- Inflammatory markers (ESR, CRP, and IL-6) were significantly lower with fondaparinux at multiple time points.
- Knee circumference decreased significantly more with fondaparinux on postoperative days 3 and 7; pain and blood loss did not differ significantly.
Why it matters
The findings suggest that fondaparinux may influence postoperative coagulation and inflammation, as well as knee swelling, in high-risk patients undergoing ACL reconstruction. However, because neither group had a reported VTE event and the study found no significant difference in bleeding or other postoperative complications, the results do not establish comparative protection against major clinical events.
What to keep in mind
The study was single-centre and included 72 patients; no VTE events occurred, limiting comparison of the treatments for prevention of these clinical outcomes.