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During the past few years, low-molecular-weight heparins and fondaparinux (Arixtra) have supplanted unfractionated heparin and warfarin as the favored options for preventing venous thromboembolism (VTE) after joint replacement. These anticoagulants are given subcutaneously once or twice daily for as long as 1 month after surgery. In Europe, treatment is started 1 day before surgery, whereas, in North America, it is generally begun the day after surgery. Although these prophylactic regimens have greatly lowered the incidence of VTE, they are associated with a small but definite risk for bleeding, and they require that either the patient or a caregiver perform injections. Therefore, efforts have been under way to develop oral anticoagulants t…