title: Clinical experience with novel oral anticoagulants for thromboprophylaxis after elective hip and knee arthroplasty.
abstract: Anticoagulant medications help to reduce the risk of thromboembolic events after total hip arthroplasty and total knee arthroplasty. Traditionally, this has been accomplished with medications, such as low-molecular-weight heparin and warfarin. However, these traditional anticoagulants possess a variety of shortcomings that leave much room for improvement. A new class of oral anticoagulants is now available, and present a more convenient option for safe and efficacious thromboprophylaxis in post arthroplasty patients, particularly in the outpatient setting. This review focuses on the direct thrombin inhibitor, dabigatran, and the selective factor Xa inhibitors, rivaroxaban and apixaban, and the clinical data to date about their use in total hip arthroplasty and total knee arthroplasty patients.
authors.affiliation: From the Department of Orthopaedics, Medical University of South Carolina, Charleston.
authors.forename: Cory
authors.initials: C
authors.lastname: Messerschmidt
authors.affiliation: From the Department of Orthopaedics, Medical University of South Carolina, Charleston. friedman@musc.edu.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Friedman
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D000991:Antithrombins / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001562:Benzimidazoles / Q000008:administration & dosage; D000069604:Dabigatran; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D065427:Factor Xa Inhibitors / Q000008:administration & dosage; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage; D011720:Pyrazoles / Q000008:administration & dosage; D011728:Pyridones / Q000008:administration & dosage; D012307:Risk Factors; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D011720:Pyrazoles; D011728:Pyridones; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran
keywords: anticoagulant agents; pulmonary embolism; venous thrombosis