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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(06): e883-e887
DOI: 10.1055/s-0044-1785510
Artigo Original
Joelho

The Comparison of Aspirin and Direct Oral Anticoagulant as Thromboprophylaxis Following Total Knee Replacement: A Retrospective Study

Artikel in mehreren Sprachen: português | English
Endrotomo Sumargono
1   Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Jakarta, Indonésia
2   Faculdade de Medicina, Universitas Katolik Indonesia Atma Jaya, Indonésia
,
Maria Anastasia
2   Faculdade de Medicina, Universitas Katolik Indonesia Atma Jaya, Indonésia
,
Leonard Christianto Singjie
2   Faculdade de Medicina, Universitas Katolik Indonesia Atma Jaya, Indonésia
,
Ifran Saleh
1   Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Jakarta, Indonésia
3   Departamento de Cirurgia Ortopédica, Faculdade de Medicina, Universitas Indonesia, Jakarta, Indonésia
,
Ira Juliet Anestessia
4   Faculdade de Medicina, Universitas Trisakti, Jakarta, Indonésia
,
Erica Kholinne 
1   Departamento de Cirurgia Ortopédica, St. Carolus Hospital, Jakarta, Indonésia
4   Faculdade de Medicina, Universitas Trisakti, Jakarta, Indonésia
› Institutsangaben Financial Support The authors declare that this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Objective Venous thromboembolism (VTE) is still a major challenge after major orthopaedic surgery, including total knee replacement (TKR). The aim of this study was to estimate the risk of VTE with aspirin-only pharmacologic prophylaxis following primary TKR surgery versus direct oral anticoagulant (DOAC).

Methods The study included 476 patients who underwent primary TKR from 2016 to 2020. All patients received thromboprophylaxis with DOAC (DOAC group) (n = 267) or aspirin (aspirin group) (n = 209). Clinical outcomes were evaluated and compared between those who received DOAC and aspirin. The primary outcome was the incidence of VTE. The secondary outcome was wound complications.

Result Aspirin and DOAC were comparable in preventing VTE in patients who underwent primary TKR. The incidence of deep vein thrombosis was similar in the aspirin (10%) and factor Xa inhibitor groups (10.1%), (p = 0.98) with zero case of pulmonary emboli in both groups. There was no significant difference between the aspirin (1.4%) and DOAC groups (1.5%) regarding wound complication (p = 0.95).

Conclusion Postoperative thromboprophylaxis with aspirin only was not associated with a higher risk of postoperative VTE compared with DOAC following TKR. Considering the wide availability and cost-effectiveness, aspirin may serve as a promising alternative to DOAC for VTE prophylaxis.

Keywords

anticoagulants - arthroplasty, replacement, knee - venous thromboembolism

Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Maria Anastasia and Leonard Christianto. All authors read and approved the final manuscript.


Work carried out the Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia.




Publikationsverlauf

Eingereicht: 04. März 2023

Angenommen: 21. Juli 2023

Artikel online veröffentlicht:
21. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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