Aspirin for Elective Hip and Knee Arthroplasty: a Multimodal Thromboprophylaxis Protocol

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2012 Jun 12

PMID 22684546

Citations 23

Authors

Ettore Vulcano

Mark Gesell

Amanda Esposito

Yan Ma

Stavros G Memtsoudis

Alejandro Gonzalez Della Valle

Affiliations

Soon will be listed here.

Abstract

Purpose: Multimodal thromboprophylaxis includes preoperative thromboembolic risk stratification and autologous blood donation, surgery performed under regional anaesthesia, postoperative rapid mobilisation, use of pneumatic compression devices and chemoprophylaxis tailored to the patient's individual risk. We determined the 90-day rate of venous thromboembolism (VTE), other complications and mortality in patients who underwent primary elective hip and knee replacement surgery with multimodal thromboprophylaxis.

Methods: A total of 1,568 consecutive patients undergoing hip and knee replacement surgery received multimodal thromboprophylaxis: 1,115 received aspirin, 426 received warfarin and 27 patients received low molecular weight heparin and warfarin with or without a vena cava filter.

Results: The rate of VTE, pulmonary embolism, proximal deep vein thrombosis (DVT) and distal DVT was 1.2, 0.36, 0.45 and 0.36 %, respectively, in patients who received aspirin. The rates in those who received warfarin were 1.4, 0.9, 0.47 and 0.47 %, respectively. The overall 90-day mortality rate was 0.2 %.

Conclusions: Multimodal thromboprophylaxis in which aspirin is administered to low-risk patients is safe and effective following primary total joint replacement.

Citing Articles

Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis.

Mirghaderi P, Pahlevan-Fallahy M, Rahimzadeh P, Habibi M, Pourjoula F, Azarboo A J Orthop Surg Res. 2024; 19(1):848.

PMID: 39702480 PMC: 11657554. DOI: 10.1186/s13018-024-05356-w.

A Comparison between Enoxaparin and Aspirin in Preventing Deep Vein Thrombosis after Spine Surgery: A Randomized Clinical Trial.

Kavian A, Rezaee H, Darvari S, Mehrad-Majd H, Mashhadinejad H Arch Bone Jt Surg. 2024; 12(6):412-417.

PMID: 38919740 PMC: 11195039. DOI: 10.22038/ABJS.2024.74693.3458.

Aspirin or enoxaparin for VTE prophylaxis after primary partial, total or revision hip or knee arthroplasty: A secondary analysis from the CRISTAL cluster randomized trial.

PLoS One. 2024; 19(4):e0298152.

PMID: 38626226 PMC: 11020928. DOI: 10.1371/journal.pone.0298152.

Venous thromboembolism testing practices after orthopaedic trauma: prophylaxis regimen does not influence testing patterns.

Haac B, OHara N, Haut E, Manson T, Slobogean G, OToole R OTA Int. 2024; 7(2):e331.

PMID: 38623266 PMC: 11013691. DOI: 10.1097/OI9.0000000000000331.

Aspirin is a safe and effective thromboembolic prophylaxis after total knee arthroplasty: a systematic review and meta-analysis.

Za P, Papalia G, Franceschetti E, Rizzello G, Adravanti P, Papalia R Knee Surg Sports Traumatol Arthrosc. 2023; 31(10):4407-4421.

PMID: 37449989 DOI: 10.1007/s00167-023-07500-1.

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