Incidence of thromboembolic complications after hip and knee arthroplasty: Interest of systematic post-operative Doppler exploration

Havé, L.; Tondeur, G; Fournel, C.; Jacquin, O.; Goldet, R.

doi:10.1016/j.rehab.2012.07.144

Cited by 1 publication

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“…Asymptomatic DVT was a potential threat to patient health. Havé et al [41] suggested that the majority DVT of patients were asymptomatic and it would be interesting to identify DVT in a systematic manner in patients after knee arthroplasty. Rivaroxaban also showed a better anticoagulant effect of asymptomatic DVT, compared with enoxaparin in our study.…”

Section: Discussionmentioning

confidence: 99%

Rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total knee arthroplasty

Huang

Yang

et al. 2018

Medicine

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Objective:This article analyzed the clinical efficacy and tolerability of rivaroxaban and enoxaparin in patients undergoing total knee arthroplasty (TKA) surgery.Methods:Five randomized, controlled clinical trials on rivaroxaban versus enoxaparin in patients who underwent TKA were identified and included in this meta-analysis.Results:The meta-analysis indicated that rivaroxaban prophylaxis was associated with lower rates of symptomatic venous thromboembolism (VTE) (relative risk[RR]:0.55; 95% confidence interval [CI]: 0.35–0.86; P = .009), symptomatic deep vein thrombosis (DVT) (RR 0.44, 95% CI 0.25–0.80, P = .007), asymptomatic DVT (RR: 0.57; 95% CI: 0.37–0.89; P = .01), distal DVT (RR: 0.62; 95% CI: 0.45–0.85; P = .003) and proximal DVT (RR: 0.42; 95% CI: 0.24–0.75; P = .004). Compared with the enoxaparin group, the incidence of symptomatic pulmonary embolism (PE) (RR: 0.48; 95% CI: 0.19–1.24; P = .13) in the rivaroxaban group was not significantly different. A nonsignificant trend towards all-cause death (RR: 0.38; 95% CI: 0.03–4.92; P = .46) or major bleeding (RR: 1.59; 95% CI: 0.77–3.27; P = .21) risk between rivaroxaban and enoxaparin prophylaxis was found.Conclusion:Compared with the enoxaparin group, the group using rivaroxaban after TKA had a significantly lower rate of symptomatic VTE, symptomatic DVT, asymptomatic DVT, distal DVT, and proximal DVT. Our study shows that rivaroxaban after TKA is more effective than enoxaparin and did not increase major bleeding or all-cause mortality.Level of evidence II

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Section: Discussionmentioning

confidence: 99%