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November 18, 2013MUSCULOSKELETAL SURGERYOpen Access

Practical management of new oral anticoagulants after total hip or total knee arthroplasty

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Key result

Direct oral anticoagulants such as rivaroxaban, apixaban, and dabigatran offer practical advantages over conventional agents for VTE prevention after hip or knee arthroplasty, including oral administration and no need for routine coagulation monitoring.

Why the study?

What is the optimal practical management of new oral anticoagulants for the prevention of venous thromboembolism in adult patients after elective hip or knee arthroplasty?

Population

Adult patients after elective hip or knee arthroplasty

Comparison

New oral anticoagulants vs Conventional anticoagulants

Design

Review

Authors

WKWolfgang KlauserUniversity of UtahMDM. DütschHelios Endo-Klinik Hamburg

Discussion

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Implication

May guide DOAC selection post-arthroplasty; leaves open head-to-head efficacy and safety data.

Structured PICO

What is the optimal practical management of new oral anticoagulants for the prevention of venous thromboembolism in adult patients after elective hip or knee arthroplasty?

P
Population
Adult patients after elective hip or knee arthroplasty
I
Intervention
New oral anticoagulants (rivaroxaban, apixaban, dabigatran etexilate)
C
Comparator
Conventional anticoagulants
O
Outcome
Prevention of venous thromboembolism and practical management

This review provides practical guidance and single-institution experience on managing new oral anticoagulants for VTE prevention following hip or knee arthroplasty.

Limitations

  • Clinical experience with these newer oral agents is relatively limited, especially for apixaban.
  • No specific antidotes are currently available to fully reverse the effects of direct oral anticoagulants.

Cite This Study

Klauser et al. (2013) conducted a review in Venous thromboembolism prevention after total hip or total knee arthroplasty. Direct oral anticoagulants (rivaroxaban, apixaban, dabigatran) vs. Conventional anticoagulants (LMWH, UFH, VKAs) was evaluated. Direct oral anticoagulants such as rivaroxaban, apixaban, and dabigatran offer practical advantages over conventional agents for VTE prevention after hip or knee arthroplasty, including oral administration and no need for routine coagulation monitoring.

synapsesocial.com/papers/6a229ca3d4af8d4f35118af0https://doi.org/10.1007/s12306-013-0306-8

Topics

Dual antiplatelet therapyAnticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Apixaban or Enoxaparin for Thromboprophylaxis after Knee Replacement2009 · 696 citations
  2. 2Apixaban versus Enoxaparin for Thromboprophylaxis after Hip Replacement2010 · 781 citations
  3. 3Evaluation of the anti-factor Xa chromogenic assay for the measurement of rivaroxaban plasma concentrations using calibrators and controls2011 · 232 citations
  4. 4Rivaroxaban versus Enoxaparin for Thromboprophylaxis after Total Knee Arthroplasty2008 · 1,302 citations
  5. 5Assessment of laboratory assays to measure rivaroxaban – an oral, direct factor Xa inhibitor2010 · 449 citations