Aspirin Can Be Used as Prophylaxis for Prevention of Venous Thromboembolism After Revision Hip and Knee Arthroplasty.
The optimal prophylaxis for prevention of venous thromboembolic events (VTEs) after revision total joint arthroplasty (TJA) remains unknown. The objective of this study was to evaluate whether aspirin, known to be effective for prevention of VTEs after primary arthroplasty, is also effective after revision TJA.



We studied 2997 consecutive patients who underwent revision TJA between 2005 and 2013 and were treated with intermittent pneumatic compression devices and either aspirin (534 patients) or warfarin (2463 patients) for VTE prophylaxis. Pertinent data including the incidence of symptomatic VTEs, bleeding events, infection, and mortality were retrieved from our prospectively collected database.



The incidence of symptomatic VTEs was significantly higher in the warfarin group at 1.75% (43 of 2463) compared with 0.56% (3 of 534) in the aspirin group (odds ratio: 3.2; 95% CI: 1.03-16.3; P = .03). There was a higher rate of bleeding events with administration of warfarin (1.5%) compared with aspirin (0.4%; P = .02; odds ratio: 4.1; 95% CI: 1.2-34.0). The rate of surgical site infection was similar between the aspirin group and the warfarin group (1.61% and 1.70%, respectively).



Administration of aspirin as prophylaxis against VTEs after revision arthroplasty may be a viable option as it appears to be more effective than warfarin in prevention of symptomatic VTEs and is associated with a lower rate of complications.
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Gregory K
GK
Deirmengian
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Snir
S
Heller
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Eric B
EB
Smith
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Mitchell
M
Maltenfort
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Antonia F
AF
Chen
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Javad
J
Parvizi
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015143:Philadelphia / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D001241:Aspirin
aspirin; complications; deep vein thrombosis; pulmonary embolism; total joint arthroplasty; venous thromboembolism