Thromboprophylaxis after Arthroplasty in Practice of Outpatient Trauma and Orthopedic Physician: is it necessary?

Analysis of the safety and efficacy of the currently marked oral anticoagulants in patients after large joints arthroplastyat outpatient step was presented for the first time in Russian clinical practice. Total number of 5025 patients after total knee and 5216 patients after total hip arthroplasty were examined. All patients were divided into 3 groups depending on prescribed anticoagulant (dabigatran, rivaroxaban or apixaban). Duration of therapy with corresponding drug after hip and knee arthroplasty was initiated after surgery and made up 35 and 45 days, respectively. Deep vein US examination was performed to all patients in 3 and 6 months after discharge. In patients on dabigatran the rate of clinically significant deep vein thrombosis development was lower than in patients on rivaroxaban and apixaban, and made up 5% vs 7.7 and 16%, respectively. Rate of nonfatal pulmonary embolism (PE) was comparable. Relapse of deep vein embolism development was diagnosed only in patients who received rivaroxaban. A suggestion on the expediency of a longer thromboprophylaxis after surgical interventions on large joints was made that would require extensive studies.