Comparing LMWHs in Preventing DVT Post-ACLR: Enoxaparin vs Nadroparin

In patients undergoing anterior cruciate ligament reconstruction (ACLR), nadroparin was associated with a lower rate of postoperative lower‑limb deep‑vein thrombosis (DVT) than enoxaparin in a single‑center retrospective cohort.

In a retrospective study of 189 consecutive adults who underwent ACL reconstruction between January 2022 and January 2023 at a tertiary sports‑medicine center, allocated to nadroparin (n=94) or enoxaparin (n=95), the primary endpoint was postoperative lower‑limb DVT detected by routine color Doppler ultrasound, with symptomatic and asymptomatic events distinguished. Patient selection focused on primary ACLR under standard perioperative care; the published report provides limited exclusion details.

Overall DVT incidence was significantly lower in the nadroparin group than in the enoxaparin group (P<0.05), with proximal/distal breakdowns and symptomatic event rates favoring the nadroparin arm where reported. The directional consistency across total, proximal/distal, and symptomatic events supports a clinically meaningful reduction in venous thromboembolic burden after ACLR in this series.

Coagulation indices measured at prespecified postoperative intervals also favored nadroparin, with a smaller mean activated partial thromboplastin time at one month and lower fibrinogen and D‑dimer values at postoperative day 7 and one month (P<0.05). No significant differences were reported for the remaining laboratory or clinical safety indicators, and major bleeding events were not described as increased in either group in the available summary. Taken together, the safety data as reported show improved coagulation markers with nadroparin without a clear increase in bleeding signals.

Key Takeaways:

• Nadroparin was associated with a lower incidence of postoperative lower‑limb DVT than enoxaparin in this retrospective ACLR cohort.
• Routine color Doppler surveillance identified fewer deep venous and intramuscular thromboses in the nadroparin group; differences were reported as statistically significant.
• Early postoperative coagulation markers (aPTT, fibrinogen, D‑dimer) favored nadroparin without a reported increase in major bleeding events.