Prevention of thrombus formation after endoprosthesis in ambulatory practice of orthopedic traumatologists

Introduction. For the first time in the Russian clinical practice, an analysis of safety and efficacy of oral anticoagulants available in the pharmaceutical market, was performed in patients after endoprosthesis of large joints, in the outpatient stage. Material and Methods. The study included 5.025 patients after total knee joint replacement, and 5.216 patients - after hip joint surgery. Results. All patients were divided into three groups based on the prescribed anticoagulant (dabigatran, rivaroxaban and apixaban). The duration of anticoagulant therapy after endoprosthesis of the hip and knee joints lasted 35 and 45 days from the time of surgery, respectively. All patients underwent ultrasound examination of the lower extremity veins 3 and 6 months after being discharged from the hospital. In the group of the patients taking dabigatran, the incidence of clinically significant deep vein thrombosis was lower than among the patients receiving rivaroxaban and apixaban, accounting for 5% versus 7.7% and 16%, respectively. The incidence of non-fatal pulmonary thromboembolism was comparable. The occurrence of rethrombosis (recurrent deep vein thrombosis) was noted only in the rivaroxaban group. Conclusion. An assumption was put forward that extended treatment for prevention of thrombus formation after surgery of large vessels is expedient, but it requires conduct of large scale studies.