Systematic review of aspirin for thromboprophylaxis in modern elective total hip and knee arthroplasty

Evidence from one good quality randomized controlled trial showed no difference in rates of venous thrombo-embolism (VTE) in patients given aspirin or low molecular weight heparin following total knee arthroplasty.

• Aspirin may be as effective as low molecular weight heparin for preventing VTE after total knee arthroplasty.
• Insufficient evidence exists to determine if aspirin is more or less effective than warfarin or dabigatran in preventing VTE in total hip and knee arthroplasties.
• Rates of asymptomatic deep vein thrombosis may be lower with rivaroxaban compared to aspirin in total knee arthroplasty.
• Dabigatran and rivaroxaban are associated with more wound complications than aspirin following total hip and knee arthroplasties.
• Concerns over bleeding complications and the efficacy of aspirin were noted in some studies.

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