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Great strides have been made in surgery for degenerative joint disease, but preventing postprocedural venous thromboembolism (VTE) remains problematic. Although conventional antithrombotic agents are effective in reducing VTE in this setting, acceptance is limited by the associated risks for bleeding and the need for injections or monitoring.
To evaluate the benefits and harms of new oral antithrombotic agents that do not require monitoring (direct factor Xa inhibitors, including apixaban, edoxaban, and rivaroxaban), an international team of investigators conducted a meta-analysis of 22 randomized trials that compared factor Xa inhibitors with low-molecular-weight heparin (mainly enoxaparin) in adults who underwent total hip or knee replacem…