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Beitragstitel Use of Aspirin versus Rivaroxaban in postoperative thromboembolic prophylaxis after primary total hip and knee arthroplasty
Autoren
  1. Simon Donkerwolke Vortragender
  2. Jean-François Fischer eHnv Hôpital Yverdon Les Bains
  3. Philip Deslarzes eHnv Hôpital Yverdon Les Bains
  4. Sami Abou-Khalil eHnv Hôpital Yverdon Les Bains
  5. Thibaut Royon CHUV - Centre hospitalier universitaire vaudois Vortragender
Präsentationsform Poster
Themengebiete
  • A08 - Grundlagenforschung
Abstract Goal of the study
To compare the efficiency of Aspirin and Rivaroxaban in the thromboembolic prophylaxis after Total Hip (THA) and Knee (TKA) Arthroplasty: a multicenter comparative retrospective study.
Introduction
The Total Hip and Knee Arthroplasties have seen an increase in recent years due to population aging, leading to more thromboembolic post-operative complications. Different drugs are effective in preventing these complications, but none of them stands out. To this date, we are not aware of any Swiss studies comparing the effectiveness of Aspirin with that of Rivaroxaban. The main objective of the study is to find out whether Aspirin is as effective as Rivaroxaban in thromboembolic prophylaxis in primary THA and TKA.
Patients and methods
Multicenter comparative retrospective study including all patients who underwent primary THA or TKA between January 2017 and November 2020, in two different hospitals. Patients who presented previously thromboembolic event, admitted for fracture or revision surgery, or under preoperative therapeutic anticoagulation were excluded.
All included patients received postoperative thromboembolic prophylaxis for a total of 4 weeks, with Heparin during hospitalization period followed by Rivaroxaban 10 mg once a day or by Aspirin 100 mg twice a day. The rehabilitation protocol was the same for all (full load bearing from day zero or day one). We used our computer database files to search thromboembolic events and deaths occurring within 90 days after surgery. SPSS statistical software and the Chi2 test were used.
Results
828 patients were included (58 % THA: n = 481; 42 % TKA: n = 347). 54,5 % (n = 451) took Rivaroxaban and 45,5 % (n = 377) took Aspirin. Two cases of Deep Vein Thrombosis were observed with Aspirin (0.53 %), none occurred with Rivaroxaban. The difference was not significant (p = 0.125). We did not observe any deaths or pulmonary embolism. The two cases of deep vein thrombosis belong to the THA group, none occurred in TKA.
Conclusion
Aspirin and Rivaroxaban both appear to be effective in preventing thromboembolic events after primary THA or TKA. Aspirin offers the possibility of rapid surgical revision in the event of post-operative hematoma or early acute infection, does not require laboratory monitoring and has very few side effects. Its low cost and availability are also advantages. The exact dosage and the minimum prescription period remain controversial, requiring further randomized studies.
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