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Efficacy and safety of postoperative single-dose anticoagulant treatment in preventing venous thromboembolism after revision hip arthroplasty: a retrospective cohort study

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Abstract

Purpose

The purpose of the study is to determine the efficacy and safety of postoperative single-dose anticoagulant treatment in preventing venous thromboembolism (VTE) after revision THA, in comparison with a multiple-dose chemoprophylaxis protocol.

Methods

We retrospectively compared 295 patients undergoing revision THA who received multiple-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once and oral rivaroxaban for 10 days) or single-dose chemoprophylaxis protocol (40 mg low-molecular-weight heparin once) for VTE. The patients in both groups performed active lower limb exercises. Each group was further stratified into subgroups based on the aetiology of revision. The incidence of VTE, wound complications within three months, hidden blood loss (HBL), transfusion rate, and surgical drainage duration were recorded.

Results

The incidence rates of VTE (P = 0.870) did not differ between the two prophylaxis protocols. However, significant differences were observed in wound complications within three months (P = 0.002), HBL (P = 0.015), transfusion rate (P = 0.028). Surgical drainage duration was also shorter in the single-dose chemoprophylaxis group (P = 0.0023). In the subgroup analysis, the use of single-dose chemoprophylaxis protocol cannot significantly reduce HBL and transfusion rate after septic revision THA. The use of multiple-dose chemoprophylaxis protocol (OR = 2.89, P = 0.002) and high BMI (OR = 1.09, P = 0.037) were independent risk factors of wound complications.

Conclusions

Single-dose chemoprophylaxis protocol effectively and safely prevented VTE after revision THA compared with multiple-dose chemoprophylaxis protocol. The effect in reducing HBL and postoperative transfusion rate was limited in septic revision.

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Data availability

The data that support the findings of this study are available from the corresponding author upon 304 reasonable request.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (No.82260435), and the Natural Science Foundation of Xinjiang (2021D01C331).

Author information

Author notes

  1. Chenghan Chu and Wenbo Mu contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Chenghan Chu, Wenbo Mu, Tuerhongjiang Wahafu, Chen Zou, Boyong Xu & Li Cao

  2. College of Pharmacy, Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Wenbo Mu

  3. Ministry of Education, Key Laboratory of High Incidence Disease Research in Xinjiang(Xinjiang Medical University, Urumqi, 830054, Xinjiang, China

    Li Cao

  4. Xinjiang Clinical Research Center for Orthopedics, Urumqi, 830054, Xinjiang, China

    Li Cao

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  1. Chenghan Chu
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Contributions

All authors contributed to the study conception and design. Chenghan Chu and Wenbo Mu contributed equally to the work described in the article and share first co-author status. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Li Cao.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of First Affiliated Hospital of Xinjiang Medical University (K202208-02).

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data and photographs.

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The authors declare no competing interests.

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Chu, C., Mu, W., Wahafu, T. et al. Efficacy and safety of postoperative single-dose anticoagulant treatment in preventing venous thromboembolism after revision hip arthroplasty: a retrospective cohort study. International Orthopaedics (SICOT) 47, 2709–2716 (2023). https://doi.org/10.1007/s00264-023-05893-9

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