Factor Xa Inhibitors and Direct Thrombin Inhibitors Versus Low-Molecular-Weight Heparin for Thromboprophylaxis After Total Hip or Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Thirty-two randomized controlled studies were analyzed, revealing that LMWH is associated with a higher rate of VTE than factor Xa inhibitors in total knee and hip arthroplasty patients.

• LMWH provided better protection against VTE than placebo.
• Factor Xa inhibitors resulted in lower rates of VTE compared to LMWH in both TKA and THA patients.
• In THA patients, the rate of deep vein thrombosis (DVT) was lower with factor Xa inhibitors than LMWH.
• In TKA patients, the rates of VTE and DVT were similar between LMWH and direct thrombin inhibitors.
• Direct thrombin inhibitors were associated with a lower rate of VTE in THA patients, but had similar effectiveness to LMWH concerning DVT and pulmonary embolism.

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