Venous Thromboembolism Prophylaxis After “Nonmajor” Lower-Limb Orthopedic Procedures

In a randomized trial with substantial limitations, rivaroxaban was barely superior to enoxaparin.

Whether prophylaxis against venous thromboembolism (VTE) is warranted after so-called nonmajor lower-limb orthopedic procedures is controversial. In this study, researchers randomized 3600 patients to receive either oral rivaroxaban or subcutaneous enoxaparin after nonmajor lower-limb orthopedic surgery.

Patients were included “according to the investigator's assessment of the patient's venous thromboembolic risk.” The most common procedures were knee ligament repair (37%), ankle fracture surgery (15%), complicated knee arthroscopy (9%), tibial osteotomy (6%), tibial fracture surgery (5%), and Achilles tendon repair (5%). VTE prophylaxis was provided until the end of immobilization, which averaged 1 month. To detect asymptomatic proximal dee…

Reviewing Authors

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Richard J Friedman, MD, FRCSC

Venous Thromboembolism Prophylaxis After “Nonmajor” Lower-Limb Orthopedic Procedures

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Reviewing Authors