Venous thromboembolic (VTE) and infectious complications are the most common events after large joint arthroplasty.

OBJECTIVE

To compare an efficacy and safety of acetylsalicylic acid (ASA) and rivaroxaban for VTE prevention after primary knee arthroplasty followed by early revitalization of patients.

MATERIAL AND METHODS

The study included 189 patients. The 1st group consisted of 92 patients (ASA), the 2nd group — 97 patients (rivaroxaban). An efficiency of VTE prophylaxis was evaluated considering the incidence of deep vein thrombosis (DVT) and pulmonary embolism, therapeutic safety was assessed in accordance with the incidence of hemorrhagic complications in 1—5 and 35 days after surgery.

RESULTS

Asymptomatic distal DVT within 5 days after surgery was detected in 26.1% of patients in the 1st group and in 13.4% of the 2nd group. There were no cases of pulmonary embolism. VTE de novo within 35 days was observed in 2 patients (including proximal thrombosis in 1 case) of the 1st group. There were no VTEs in the 2nd group. A 35-day incidence of VTE was 28.3 and 13.4% in both groups, respectively. Hemorrhagic complications occurred in 16.3% of patients in the 1st group and in 9.3% of the 2nd group, profuse wound discharge — in 12.3 and 5.2% of patients, respectively. Severe bleeding from the postoperative wound followed by antithrombotic therapy discontinuation on the 1st postoperative day occurred in 3.3% and 4.1% of patients in both groups, respectively. The ratio of VTE treatment cost to VTE prevention cost was significantly higher in the 1st group compared to the 2nd group.

CONCLUSION

Incidence of VTE following knee arthroplasty was significantly higher in the ASA group compared to rivaroxaban. ASA intake was also followed by slightly higher incidence of hemorrhagic complications. In the vast majority of cases, proximal DVT was not recorded in both groups. There were no cases of pulmonary embolism. Further studies are needed to justify the use of ASA after knee arthroplasty.