Key result
Rivaroxaban treatment after total knee replacement significantly increased the blood transfusion rate to 49.59% compared to 35.09% in the nonanticoagulant group, while reducing knee swelling and preventing deep vein thrombosis.
Why the study?
Does rivaroxaban increase hidden blood loss and blood transfusion rate while preventing DVT in patients with knee osteoarthritis undergoing total knee replacement?
RCT (n=235)
Randomly generated using Excel RNAD() function
No
Does rivaroxaban increase hidden blood loss and blood transfusion rate while preventing DVT in patients with knee osteoarthritis undergoing total knee replacement?
Rivaroxaban effectively prevents DVT after total knee replacement but significantly increases hidden blood loss and the need for blood transfusions.
Rivaroxaban raises transfusion risk after TKR despite DVT prevention; confirms bleeding-thrombosis trade-off in orthopedic prophylaxis.
Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The purpose of the current study is to investigate effects rivaroxaban had on both hidden blood loss and blood transfusion rate (BTR) in patients with knee OA (KOA) after going through a total knee replacement (TKR).Between the time periods of December 2011 up until January 2015, a total of 235 patients underwent TKR and were selected to be assigned to either the rivaroxaban or nonanticoagulant groups. Coagulation function indexes before surgery and following administration of rivaroxaban, total blood loss, hidden blood loss, dominant blood loss, blood transfusion volume, hemoglobin reduction, degree of postoperative pain (visual analogue scale), the degree of knee swelling, and range of motion following surgery were all recorded. Hospital for special surgery (HSS) scores offered an objective evaluation for the knee joint functions before surgery at the intervals of 2 weeks and after surgery at intervals of 3 months, 6 months, 12 months, and 24 months.Patients in the rivaroxaban group had shown a higher hidden blood loss, as well as a higher BTR, compared to those involved in the nonanticoagulant group. BTR was found to have been 49.59% in the rivaroxaban group, and 35.09% for the nonanticoagulant group. Patients in the rivaroxaban group had lower degrees of knee swelling than those involved in the nonanticoagulant group. There was no deep vein thrombosis (DVT) detected in the rivaroxaban group, whereas 5 DVT cases were detected in the nonanticoagulant group. In the rivaroxaban group, the HSS scores of the knee joint functions were remarkably higher at the 2-week mark in succession to the surgery than those involved with the nonanticoagulant group.This overall data demonstrated that KOA patients after TKR had presented with a higher hidden blood loss, BRT, and lower swelling degrees of the knee joint after being treated by the rivaroxaban.
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Zhang et al. (2018) conducted an RCT in Knee osteoarthritis (n=235). Rivaroxaban vs. No anticoagulation was evaluated on Blood transfusion rate (p=0.025). Rivaroxaban treatment after total knee replacement significantly increased the blood transfusion rate to 49.59% compared to 35.09% in the nonanticoagulant group, while reducing knee swelling and preventing deep vein thrombosis.
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