Key result
Aspirin demonstrated non-inferior efficacy to enoxaparin for VTE prevention following total knee or hip arthroplasty, with a 0% incidence of symptomatic VTE or bleeding events in both groups at 90 days.
Why the study?
Venous thromboembolism is a significant complication after TKA and THA, but comparative data on the efficacy and safety of aspirin versus traditional anticoagulants like enoxaparin remain limited.
Does aspirin following a brief course of enoxaparin prevent venous thromboembolism and bleeding events as effectively as a full course of enoxaparin in patients undergoing total knee or hip arthroplasty?
RCT (n=60)
Single-blind
Computer randomization (1:1 ratio)
No
Does aspirin following a brief course of enoxaparin prevent venous thromboembolism and bleeding events as effectively as a full course of enoxaparin in patients undergoing total knee or hip arthroplasty?
Absolute Event Rate: 0% vs 0%
Aspirin following a brief course of enoxaparin appears to be as effective and safe as a full course of enoxaparin for VTE prophylaxis after total hip or knee arthroplasty, though larger studies are needed due to the zero-event rate.
Supports aspirin after brief enoxaparin as VTE prophylaxis post-arthroplasty; extends evidence but leaves open confirmation in larger trials.
BACKGROUND: Venous thromboembolism (VTE) is a significant complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Aspirin has gained attention as a cost-effective, safe alternative to traditional anticoagulants like enoxaparin, but comparative data on efficacy and safety remain limited. METHODS: This randomized controlled trial compared the efficacy of aspirin and enoxaparin in preventing VTE following TKA and THA. A total of 60 patients were recruited, with 30 patients in each group. Prophylactic efficacy was assessed through Doppler ultrasonography preoperatively and at two and four weeks postoperatively. The primary outcome was the incidence of VTE or bleeding events within 90 days. Results: No cases of symptomatic deep vein thrombosis, pulmonary embolism, or other thrombotic events were observed in either group during the 90-day follow-up. Additionally, no statistically significant differences were noted between groups for bleeding events, including hematoma or hemarthrosis. Both treatments were well tolerated, with comparable safety profiles. Systemic and gastrointestinal complications were minimal and evenly distributed across groups. CONCLUSION: Our findings suggest that aspirin and enoxaparin are equally effective in preventing VTE after total knee or hip arthroplasty. Further research is needed to determine the optimal duration and dosage of aspirin for VTE prophylaxis in this setting.
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Campos-Flores et al. (2024) conducted an RCT in Total knee and hip joint replacement (osteoarthritis) (n=60). Aspirin vs. Enoxaparin 40 mg daily (or 20 mg for specific criteria) for 5 weeks was evaluated on 90-day incidence of postoperative bleeding events and prothrombotic complications (VTE). Aspirin demonstrated non-inferior efficacy to enoxaparin for VTE prevention following total knee or hip arthroplasty, with a 0% incidence of symptomatic VTE or bleeding events in both groups at 90 days.
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