Why the study?
To compare the hemostatic effect and safety of nadroparin calcium, enoxaparin sodium, rivaroxaban, or apixaban after tranexamic acid anti-fibrinolysis in primary unilateral total hip arthroplasty.
Does the choice between nadroparin, enoxaparin, rivaroxaban, or apixaban affect hemostatic effect and safety in patients undergoing primary unilateral THA after TXA?
Does the choice between nadroparin, enoxaparin, rivaroxaban, or apixaban affect hemostatic effect and safety in patients undergoing primary unilateral THA after TXA?
Different anticoagulants (nadroparin, enoxaparin, rivaroxaban, apixaban) show similar hemostatic effects and safety profiles when used after tranexamic acid in primary unilateral total hip arthroplasty.
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Anticoagulant choice appears unrelated to hemostatic outcomes or complications after TXA in THA; leaves open optimal selection pending prospective trials.
OBJECTIVE: To compare the hemostatic effect and safety in primary unilateral total hip arthroplasty (THA) receiving nadroparin calcium, enoxaparin sodium, rivaroxaban, or apixaban after anti-fibrinolysis with tranexamic acid (TXA) and explore the best anticoagulant. Perioperative blood data (total blood loss, hidden blood loss, dominant blood loss, postoperative drainage volume, maximum loss of hemoglobin, and blood transfusion rate) and complications (incision, bleeding, and thrombosis) were recorded and compared between groups. Neither deep venous thrombosis nor pulmonary embolism occurred in any group. CONCLUSION: No significant difference in the hemostatic effect and incidences of complications for patients underwent primary unilateral THA receiving nadroparin calcium, enoxaparin sodium, rivaroxaban, or apixaban after anti-fibrinolysis with TXA. One of the four anticoagulants can be selected to prevent thrombosis after anti-fibrinolysis with TXA, which has certain safety.
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Deng et al. (2020) studied this question.
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