Abstract
Objective Aspirin (acetylsalicylic acid, ASA) and rivaroxaban are anticoagulants that have
increased in popularity due to ease of use in the prevention of venous thromboembolism
(VTE) after total knee arthroplasty (TKA). The present study aimed to evaluate the
efficacy of ASA compared with that of rivaroxaban on VTE prophylaxis in patients who
underwent TKA.
Method Forty patients who had primary knee osteoarthritis and would undergo TKA were randomized
into two groups. In total, 20 patients in the ASA group used oral aspirin, at a dose
of 300 mg/day, for VTE prophylaxis after TKA, while 20 patients in the rivaroxaban
group received oral rivaroxaban, at a dose of 10 mg/day. On days 4 and 14 after the
operation, deep vein thrombosis (DVT) in the lower limbs on the operated side was
detected through duplex ultrasonography. Other complications were recorded for 14
days.
Results There were no positive findings of DVT detected with duplex ultrasonography in the
groups of patients, and the occurrence of pulmonary embolism was not observed. In
total, 4 patients had subcutaneous ecchymosis on the fourth postoperative day (2 patients
in the ASA group and 2 patients in the rivaroxaban group; p = 1.0), and another 4 patients on the fourteenth postoperative day (1 patient in
the ASA group and 3 patients in the rivaroxaban group; p = 0.292). No cases of wound hematoma, major organ bleeding, wound infection, or reoperation
were observed in the sample.
Conclusion Aspirin and rivaroxaban had comparable efficacy to prevent VTE, without increasing
the incidence of wound complications and bleeding after TKA.
Keywords
aspirin - rivaroxaban - arthroplasty, replacement, knee - venous thromboembolism
