Aspirin Alone for VTE Prophylaxis after Joint Replacement

In patients undergoing hip or knee replacement, the preferred pharmacologic approach for preventing venous thromboembolism (VTE) remains uncertain. In 2018, a head-to-head trial showed that aspirin was as effective as rivaroxaban; however, patients in the aspirin arm received rivaroxaban for 5 days before switching to aspirin, which left uncertainty on whether an aspirin-only approach would have the same result (Figure 1).

To address this uncertainty, researchers randomized 5400 people (mean age, 66) who underwent total hip or knee arthroplasty to either 81 mg aspirin alone or 10 mg rivaroxaban for 5 days followed by 81 mg aspirin; the total duration of prophylaxis in both groups was 35 days after hip surgery and 14 days after knee su…