Administration of aspirin and rivaroxaban prevents deep vein thrombosis after total knee arthroplasty

Zou Yue; Tian Shao-qi; Wang Yuan-he; Liu Jiang-jun; Sun Kang

doi:10.3969/j.issn.2095-4344.2014.13.008

Abstract：BACKGROUND:To date, rivaroxaban has been a clinical y common anticoagulant in China;however, effective prophylaxis for venous thrombosis is associated with a markedly higher incidence of perioperative hemorrhagic complications. Although it has been reported that aspirin effectively prevents deep vein thrombosis and pulmonary embolism, the use of aspirin as a routine drug for venous thrombosis after total knee arthroplasty is stil controversial. <br> OBJECTIVE:To compare the efficacy and safety of aspirin and rivaroxaban for prevention of deep vein thrombosis after total knee arthroplasty. <br> METHODS:Total y 324 patients with osteoarthritis who underwent primary unilateral total knee arthroplasty were randomly divided into three groups. Twelve hours after the surgery, three groups were given aspirin, rivaroxaban and low-molecular-weight heparin respectively. Al three groups were treated for 14 days, and al of the patients were fol owed for 4 weeks. <br> RESULTS AND CONCLUSION:Compared with the low-molecular-weight heparin group, the incidence of deep vein thrombosis was lower (P<0.05), but hidden blood loss and wound complications were more common (P<0.05) in the rivaroxaban group. There were no significant differences between the low-molecular-weight heparin group and aspirin group in the incidence of deep vein thrombosis, hidden blood loss, wound complications or incidences of lower limb swel ing and subcutaneous ecchymosis (P>0.05). The results confirmed that rivaroxaban has a positive anticoagulation effect but leads to increases in wound complications in patients;there are no differences in efficacy and safety between aspirin and low-molecular-weight heparin, so aspirin as part of a multimodal anticoagulation therapy after total knee arthroplasty has good clinical safety and efficacy.