Clot prevention following joint replacement surgery can be a huge challenge. Anticoagulation therapy may add medications, monitoring, and other considerations during recovery. However, a recent study published in the New England Journal of Medicine took another look at blood clot prevention after joint replacement. Researchers examined whether aspirin alone could provide an alternative to rivaroxaban (Xarelto) followed by aspirin.
The randomized trial included 5,429 patients following total hip or total knee arthroplasty. For the first five days after surgery, patients received either 81 mg of aspirin or 10 mg of rivaroxaban once daily. After that, both groups received aspirin. Patients who underwent knee replacement continued aspirin for nine additional days. Those who underwent hip replacement continued it for 30 additional days.
The results may make you stop and think. Symptomatic venous thromboembolism occurred in 0.48% of patients in the aspirin-alone group. It occurred in 0.45% of patients in the rivaroxaban-aspirin group. Researchers found aspirin alone was noninferior to rivaroxaban followed by aspirin for preventing symptomatic venous thromboembolism. They also found no clinically relevant difference in bleeding events.
MedPage Today also reported on the findings and what they could mean for clinicians following joint replacement surgery. Of course, medication decisions belong with the resident’s treating clinician. Individual risks and circumstances should always be considered.
We often get into a rut of doing the same old same old because it works. But what if we think outside the box a little more, as these researchers did? Research into blood clot prevention after joint replacement may give medical providers more information when evaluating treatment options.
Sure, aspirin won’t cure everything, but these findings might be worth discussing with your medical director and attending physicians. I, for one, would much rather swallow an aspirin daily than give myself an injection. I would also prefer it over having someone else give me one!
Random question: Did you ever wonder how an aspirin knows where to go after you swallow it? How does it know what to “fix”? Just asking for a friend!
Stay well and stay informed!
