Why the study?
Aggressive thromboprophylaxis after orthopaedic surgery raises bleeding concerns, increasing attention toward aspirin as a potentially safer thromboprophylactic agent.
Does aspirin prophylaxis prevent venous thromboembolism in patients following knee surgery compared to standard prophylactic agents?
Does aspirin prophylaxis prevent venous thromboembolism in patients following knee surgery compared to standard prophylactic agents?
Aspirin is as effective as LMWH and warfarin for VTE prevention following knee surgery, offering a potentially safer alternative to factor Xa inhibitors which increase bleeding risk.
Aspirin may serve as alternative to LMWH or warfarin for VTE prophylaxis after knee surgery; leaves open optimal choice pending higher-quality trials.
Venous thromboembolism (VTE) is a well-known complication following orthopaedic surgery. The incidence of this complication has decreased substantially since the introduction of routine thromboprophylaxis. However, concerns have been raised about increased bleeding complications caused by aggressive thromboprophylaxis. Attention has grown for aspirin as a safer thromboprophylactic agent following orthopaedic surgery. A systematic review using MEDLINE, Embase and Web of Science databases was undertaken to compare the effectiveness of aspirin prophylaxis following knee surgery with the current standard prophylactic agents (low molecular weight heparin [LMWH], vitamin K antagonists and factor Xa inhibitors). No significant difference in effectiveness of VTE prevention was found between aspirin, LMWH and warfarin. Factor Xa inhibitors were more effective, but increased bleeding complications were reported. As evidence is limited and of low quality with substantial heterogeneity, further research with high-quality, adequately powered trials is needed. Cite this article: EFORT Open Rev 2021;6:892-904. DOI: 10.1302/2058-5241.6.200120
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Marrannes et al. (2021) studied this question.
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