Knee Surg Relat Res.  2018 Sep;30(3):247-254. 10.5792/ksrr.17.092.

Rivaroxaban and Acetylsalicylic Acid for Prevention of Venous Thromboembolism Following Total Knee Arthroplasty in Korean Patients

Affiliations
  • 1Department of Orthopedic Surgery and Sports Medical Center and Sports Medical Research Institute, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Jeonju Korea Hospital, Jeonju, Korea.
  • 3Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, Korea. chhchoi@hanyang.ac.kr
  • 4Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hanyang University, Seoul, Korea.

Abstract

PURPOSE
To investigate the incidence of venous thromboembolism (VTE) after total knee arthroplasty (TKA) with chemoprophylaxis using acetylsalicylic acid (AA) or rivaroxaban in Korean patients.
MATERIALS AND METHODS
Between May 2011 and November 2013, 268 TKA patients (330 cases) were randomly allocated to 3 groups (group A: subcutaneous injection of 5,000 IU low-molecular-weight heparin for 2 days followed by oral administration of 100 mg AA for 5 days; group X7: oral administration of 10mg rivaroxaban for 7 days; and group X10: oral administration of 10 mg rivaroxaban for 10 days). Multidetector-row computed tomography (MDCT) was performed at 10 days and 3 months postoperatively to evaluate VTE changes.
RESULTS
The VTE incidence was 38.2%, 20.0%, and 10.0% in groups A, X7, and X10, respectively (p < 0.001). Pulmonary embolism (PE) was identified in 19.1%, 10.0%, and 2.7% in groups A, X7, and X10, respectively (p < 0.001). Proximal or symptomatic deep vein thrombosis (DVT) occurred primarily in group A, but the incidence was not significantly different among groups. On follow-up MDCT, PE was resolved completely with treatment in 29/30 (96.7%), and so was asymptomatic distal DVT in 24/27 (88.8%) without treatment.
CONCLUSIONS
Rivaroxaban had a lower incidence of overall VTE than AA, but no difference was observed in symptomatic VTE. The 10-day course of rivaroxaban had a lower incidence of overall VTE than the 7-day course.

Keyword

Knee; Arthroplasty; Venous thromboembolism; Rivaroxaban; Acetylsalicylic acid
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