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. 2012 Oct;36(10):1995-2002.
doi: 10.1007/s00264-012-1588-4. Epub 2012 Jun 12.

Aspirin for elective hip and knee arthroplasty: a multimodal thromboprophylaxis protocol

Ettore Vulcano  1 , Mark Gesell, Amanda Esposito, Yan Ma, Stavros G Memtsoudis, Alejandro Gonzalez Della Valle
Affiliations

Aspirin for elective hip and knee arthroplasty: a multimodal thromboprophylaxis protocol

Ettore Vulcano et al. Int Orthop. 2012 Oct.

Abstract

Purpose: Multimodal thromboprophylaxis includes preoperative thromboembolic risk stratification and autologous blood donation, surgery performed under regional anaesthesia, postoperative rapid mobilisation, use of pneumatic compression devices and chemoprophylaxis tailored to the patient's individual risk. We determined the 90-day rate of venous thromboembolism (VTE), other complications and mortality in patients who underwent primary elective hip and knee replacement surgery with multimodal thromboprophylaxis.

Methods: A total of 1,568 consecutive patients undergoing hip and knee replacement surgery received multimodal thromboprophylaxis: 1,115 received aspirin, 426 received warfarin and 27 patients received low molecular weight heparin and warfarin with or without a vena cava filter.

Results: The rate of VTE, pulmonary embolism, proximal deep vein thrombosis (DVT) and distal DVT was 1.2, 0.36, 0.45 and 0.36 %, respectively, in patients who received aspirin. The rates in those who received warfarin were 1.4, 0.9, 0.47 and 0.47 %, respectively. The overall 90-day mortality rate was 0.2 %.

Conclusions: Multimodal thromboprophylaxis in which aspirin is administered to low-risk patients is safe and effective following primary total joint replacement.

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Figures

Fig. 1
Fig. 1
Tree diagram illustrating VTE risk stratification process for the recommendation of chemoprophylaxis (all patients receive multimodal thromboprophylaxis)
See this image and copyright information in PMC

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