Aspirin versus Oral Anticoagulant for Prevention of Deep Venous Thrombosis after Arthroplasty A systematic review

Abstract

otal hip arthroplasty (THA) is one of the most successful orthopedic surgical procedures. In patients with degenerative hip joint cartilage pathologies, this technique offers significant pain relief, improved quality of life, and increased mobility in the medium- and long-terms. (1) By 2030, the number of arthroplasties is projected to increase by 170% worldwide. An increase in the complication rates is expected to follow. Thromboembolic events are considered to be common postoperative complications of hip arthroplasty. Nonetheless, their prophylaxis is still questioned in two ways: the need to prevent avoidable complications, such as deep venous thrombosis (DVT) and pulmonary embolism (PE), and to reduce the risk of hemorrhage. Oral anticoagulants aim to improve these indices, seeking efficacy in prophylaxis and to reduce the adverse effects through a more acceptable route of administration. (1) Thromboembolic events are observed in 50–60% of the patients who undergo hip arthroplasty in the absence of thromboprophylaxis; the great majority of cases do not present clinical manifestations. Studies indicate the first peak risk of DVT and PE to be between 3rd and 5th days after surgery in both THA and TKA. The second peak risk in THA is between the third and fourth postoperative weeks more specifically