Aspirin versus rivaroxaban in postoperative bleeding after total knee arthroplasty: a retrospective case-matched study
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Venous thromboembolic disease (VTE) is a complication not uncommon following total knee arthroplasty. Postoperative bleeding-related complications are a concern in many guidelines. The authors aimed to compare the amount of postoperative drainage from closed suction drainage, transfusion rate, and postoperative complications between aspirin and rivaroxaban as VTE prophylaxes after total knee arthroplasty.
This study was a retrospective case-matched study of 155 patients. The data were collected between 2008 and 2015 from patients who had total knee arthroplasty using aspirin or rivaroxaban as the VTE prophylaxis. Seventy-nine patients received aspirin, and 76 patients received rivaroxaban. A single surgeon operated on all patients with the same surgical technique and patient care protocol.
The total closed suction drainage outputs at 48 h were not significantly different between the aspirin and rivaroxaban groups (p = 0.10). Eighteen percent of patients in the aspirin group and 25% of patients in the rivaroxaban group received blood transfusions (p = 0.37). There were no bleeding-related complications or VTE in either group.
Aspirin and rivaroxaban were effective and safe as VTE chemoprophylaxis in total knee arthroplasty.
KeywordsTotal knee replacement Aspirin Rivaroxaban VTE
Venous thromboembolic disease
Body mass index (BMI)
- ASA classification
The American Society of Anesthesiologists classification
The authors wish to thank Glenn Shingledecker for his assistance in proofreading the English of this report.
VY designed the study and performed the analysis and manuscript preparation; TH designed the study and performed the data analysis; PT, CC, and CI collected data; KI designed the study and reviewed the manuscript. All authors read and approved the final manuscript.
Funding for this research was provided by the Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand (Grant No. 58-261-11-1).
Compliance with ethical standards
Conflict of interests
The authors declare that they have no competing interests.
This study was approved by the Ethics Committee and Institutional Review Board of the Faculty of Medicine, Prince of Songkla University (EC 58-261-11-1).
Consent was waived by the ethics committee. The hospital gave permission to extract information from the database.
Availability of data and materials
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
- 3.Januel JM, Chen G, Ruffieux C, Quan H, Douketis JD, Crowther MA, Colin C, Ghali WA, Burnand B, IMECCHI Group (2012) Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis: a systematic review. JAMA 307(3):294–303CrossRefGoogle Scholar
- 12.Anderson DR, Dunbar M, Murnaghan J, Kahn SR, Gross P, Forsythe M, Pelet S, Fisher W, Belzile E, Dolan S, Crowther M, Bohm E, MacDonald SJ, Gofton W, Kim P, Zukor D, Pleasance S, Andreou P, Doucette S, Theriault C, Abianui A, Carrier M, Kovacs MJ, Rodger MA, Coyle D, Wells PS, Vendittoli PA (2018) Aspirin or rivaroxaban for VTE prophylaxis after hip or knee arthroplasty. N Engl J Med 378(8):699–707CrossRefGoogle Scholar
- 13.Jacobs JJ, Mont MA, Bozic KJ, Della Valle CJ, Goodman SB, Lewis CG, Yates AC Jr, Boggio LN, Watters WC III, Turkelson CM, Wies JL, Sluka P, Hitchcock K (2012) American Academy of Orthopaedic Surgeons clinical practice guideline on: preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Bone Joint Surg Am 94:746–747CrossRefGoogle Scholar