Venous thromboembolism prophylaxis after total knee arthroplasty (TKA): aspirin vs. rivaroxaban☆

Objectives To compare the efficacy and safety of aspirin and rivaroxaban in preventing venous thromboembolism (VTE) after total knee arthroplasty (TKA). Methods Thirty-two patients with osteoarthritis of the knee and knee arthroplasty indication were selected. The operated patients were randomized into two groups (A and B). Group A received 300 mg of acetylsalicylic acid (aspirin) and Group B received 10 mg of rivaroxaban daily for 14 days. Follow-up was performed weekly for four weeks and evaluated the presence of signs and symptoms of DVT, the healing of the surgical wound, and possible local complications such as hematoma, and superficial or deep infection that required surgical approach. Results It was verified that there were no differences between groups (rivaroxaban and aspirin) regarding gender, age, and (p > 0.05). After using the general linear model (GLM) test, it was found that there was a decrease in Hb and Ht levels, preoperatively and at one, three, seven, and 14 days (Hb: p = 1.334 × 10-30; Ht: p = 1.362 × 10-28). However, they did not differ as to the type of medication (Hb: p = 0.152; Ht: p = 0.661). There were no identifiable differences in local complications, systemic complications, deep vein thrombosis (DVT), readmission to hospital, reoperation, or death (p > 0.05) between groups (rivaroxaban and aspirin). Conclusions Both aspirin and rivaroxaban can be considered useful among drugs available VTE the prevention after TKA.