Rivaroxaban Is Superior to Enoxaparin for Thromboprophylaxis After Knee and Hip Arthroplasty

Prophylactic anticoagulation is recommended practice following total knee and hip arthroplasty. Commonly used thromboprophylaxis agents include warfarin, which requires frequent monitoring, and subcutaneous low-molecular-weight heparins such as enoxaparin, which are cost-effective only if patients or their caregivers can inject the drug. In three recent manufacturer-funded trials, oral rivaroxaban (a highly selective direct factor Xa inhibitor that is prescribed at a fixed dose and does not require monitoring) was compared with subcutaneous enoxaparin for thromboprophylaxis after total knee and hip arthroplasty.

In one trial, investigators randomized 2531 patients who underwent knee arthroplasty to daily oral rivaroxaban or subcutaneous enox…