Meta-analysis: A comparison of aspirin and rivaroxaban for prophylaxis of venous thromboembolism after hip or knee arthroplasty

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BACKGROUND: Anticoagulant therapy is used in all the patients undergoing total hip or knee arthroplasty for the prophylaxis of venous thromboembolism as standard care. The anticoagulant prophylaxis considerably reduces the amount of death and complications associated with these procedures. The prophylaxis for venous thromboembolism requires immediate hip or knee arthroplasty due to formation of clots in joints. Thus the anti clotting factors need to be administered to avoid diseases progression and prevent development of new medical complications. The present study focuses upon qualitative as well as quantitative comparison of efficacy of two blood thinners (Quinlan, DJ, Eikelboom, JW, Dahl, OE, et al., 2007) which can be used after surgical interventions for deep vein thrombosis. The study takes into consideration the effects of blood thinners on clot formation and the chances of clot formation even after taking such medications as these assure. In addition to this the cost effectiveness of aspirin is another benefit and favorable factor for higher use of aspirin prescription after Total knee arthroplasty as well as total hip arthroplasty.

METHODS: The methodology for research is based upon electronic data extraction strategies with use of certain exclusion and inclusion criteria.

RESULTS: ASPIRIN [acetylsalicylic acid] inhibits the activity of cyclo-oxigenase 1 irreversibly which in turn blocks the production of TXA2 (Geerts et al., 2008). It also inhibits the deposition aggregation of platelets below the endothelium thereby acting as an antithrombotic agent. Standard dosage for prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism is 150mg per oral daily for 14 days postoperative after Total knee Replacement. Clinical trials suggest that aspirin is more effective in patients who undergo hip arthroplasty (Lee et al., 2013) and prevent the post operative complications. It is more economical with high efficiency in deep vein thrombosis

CONCLUSION: Rivaroxaban inhibits factor Xa. It is used as 10mg dose per oral daily for 14 days as a short term prophylaxis of DVT and PE. It is low molecular weight heparin which is obtained from standard heparin by chemical or enzymatic processes. It has more favorable pharmacokinetics than standard anticoagulant.

DOI 10.17605/OSF.IO/XG6H8

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