The role of newer anticoagulants in prevention of deep vein thrombosis following joint replacements

Background: Deep vein thrombosis following orthopedic surgeries particularly hip and knee arthroplasty is due to the accompanying blood vessel trauma, venous stasis, coagulation activation and older age in most of the patients. This study aims to study the efficacy of newer anticoagulants such as direct thrombin and direct factor Xa inhibitors in prevention of deep vein thrombosis (DVT) following arthroplasties. Methods: Tablet Apixaban 2.5 mg twice daily was administered for 15 days following total knee replacement (TKR) and 30 days following total hip replacement (THR) or hemiarthroplasties. Patients were examined clinically and radiologically with colour doppler of both lower limbs from 5th-13th and 30th-42th day postoperatively during follow up. Results: Only 3 out of 53 patients who underwent hip/knee arthroplasty developed DVT (p <0.05) which were found to be significant. Conclusions: The prevention of DVT in hip and knee arthoplasty using newer anticoagulant Apixaban was more efficacious, well tolerated with low rate of bleeding.