Aspirin vs. Enoxaparin for Prophylaxis After Hip or Knee Replacement

Fewer venous thromboembolic events occurred with enoxaparin, but distal deep venous thrombosis accounted for most of the difference.

Many orthopedic surgeons now prescribe aspirin for prophylaxis against venous thromboembolism after total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, the strength of the evidence favoring aspirin, compared with anticoagulants, is controversial. In this trial from Australia, 31 hospitals were randomized to give either aspirin (100 mg daily) or enoxaparin (40 mg daily) to patients undergoing THA or TKA; treatment duration was 35 days after THA and 14 days after TKA.

The trial was stopped early after 9700 patients were enrolled. The 90-day incidence of the primary outcome — any symptomatic venous thromboembolism — was significantly higher with aspirin than with enoxaparin (3.5% vs. 1.8%). However, distal (below-knee) deep …

Reviewing Authors

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Richard J. Friedman, MD, FRCSC

Aspirin vs. Enoxaparin for Prophylaxis After Hip or Knee Replacement

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