Use of oral anticoagulants for the prevention of thromboembolic events in the post-operative period of hip arthroplasty: a systematic review

Abstract

Oral anticoagulants are being used in the postoperative period of hip arthroplasty to prevent of thromboembolic events, create doubts as to the effectiveness of thromboprophylaxis and reduce the risk of hemorrhage. This systematic revision is aimed at evaluating the use of oral anticoagulants in the prevention of thromboembolic events in the postoperative period of patients undergoing hip arthroplasty. Research with descriptors found on PubMed, BVS, and the CAPES portal for medical journal publications from September 2015 to June 2016, from the last ten years (2005–2015), complete, free, and written in Portuguese and in English were the methods used. The results of the studies showed some cases of pulmonary embolism, deep vein thrombosis, and bleeding; even then, the NOACs were effective in preventing thromboembolic events. There is no consensus regarding the prophylaxis method for these events, which is why the challenge is to obtain high levels of prevention while minimizing the adverse effects. The most studied oral anticoagulant was rivaroxaban (67%). The three drugs that were studied have shown to be effective in preventing thromboembolic events, but the best results were obtained with rivaroxaban 10 mg, one tablet daily; treatment duration ranged from 30 to 35 days with oral anticoagulants and from 28 to 42 days with anti-platelet drugs.

Optimal duration of anticoagulant thromboprophylaxis in total hip arthroplasty: new evidence in 55,540 patients with osteoarthritis from the Nordic Arthroplasty Register Association (NARA) group

“…2 recently published systematic reviews based on clinical trials (Forster and Stewart 2016, Trevisol et al. 2018) both concluded that extended duration thromboprophylaxis should be considered to prevent VTE, when undergoing THA. Forster et al.…”

Is the Oral Chemical Prophylaxis Necessary for the Prevention of Venous Thromboembolism after Joint Arthroplasty in a Korean Population?

“…More recently, NOACs (new oral anticoagulants) have been shown to be effective for thromboprophylaxis after total hip arthroplasty (THA) and total knee arthroplasty in randomized controlled trials. Other studies have reported that prophylaxis with RXB for 2 weeks further reduces the risk of VTE following hip or knee arthroplasty14). The use of RXB is safe, without a statistically significant increase in severe hemorrhage or any bleeding15).…”