Rivaroxaban versus nadroparin for preventing deep venous thrombosis after total hip arthroplasty following femoral neck fractures: A retrospective comparative study

Abstract

ObjectiveThis study was performed to evaluate the efficacy of rivaroxaban versus nadroparin for preventing deep venous thrombosis (DVT) in elderly patients with osteoporosis undergoing initial total hip arthroplasty (THA) for femoral neck fractures.MethodsProspectively maintained databases were reviewed to retrospectively compare elderly patients with osteoporosis who underwent initial THA for femoral neck fractures from 2007 to 2015. The patients received peroral rivaroxaban at 10 mg/day for 2 weeks or subcutaneous injections of nadroparin at 0.3 mL/day for 2 weeks until the primary analysis cut-off date. The time to first on-study DVT was the primary endpoint.ResultsIn total, 399 patients were included (rivaroxaban group: n=200; mean age, 70.20 ± 9.16 years and nadroparin group: n = 199; mean age, 69.90 ± 8.87 years), with a mean 3-year follow-up. The time to first on-study DVT was significantly longer in the rivaroxaban than nadroparin group (12 and 5 days, respectively). The incidence of DVT within the 2-week follow-up was significantly higher in the nadroparin than rivaroxaban group (6.8% and 19.7%, respectively), but this difference was no longer present at the final follow-up.ConclusionRivaroxaban was associated with a significant reduction in the occurrence of first on-study DVT compared with nadroparin.

Equivalence of DOACS and LMWH for thromboprophylaxis after hip fracture surgery: Systematic review and meta-analysis

“…The process of article selection is presented in Figure 1. Ultimately, five studies were included (34,(39)(40)(41)(42).…”

“…All studies predominantly included elderly patients (range of mean ages 65-85 years). One study only included patients with osteoporosis and traumatic hip fractures (42). Two studies included only patients using rivaroxaban, one study included only patients using edoxaban, two studies included patients using various DOACs.…”

“…All study outcomes for the included studies are presented in Table 4. In one study, the primary study endpoint was not specified as symptomatic or asymptomatic VTE (42).…”

Effect of 3 different anticoagulants on hidden blood loss during total hip arthroplasty after tranexamic acid

“…Hong and his colleagues have shown that the occurrence rate of DVT was about 0.24% in THA, [ 37 ] and Chi et al found that the incidences of DVT were 6.8% and 19.7% with rivaroxaban and nadroparin, respectively. [ 38 ] Charters et al conducted a retrospective cohort study, including 1113 patients received enoxaparin and 649 patients received rivaroxaban after TKA and THA, and found no differences in DVT (1.8% vs 0.9%) and PE (0.7% vs 0.3%). [ 36 ] Beyer-Westendorf and his colleagues found a decrease in symptomatic DVT in 54 of 1495 patients (3.6%) who received enoxaparin compared to 20 of 1043 (1.9%) patients who received rivaroxaban, and PE rates of 0.54% and 0.19% in the enoxaparin and rivaroxaban groups, respectively.…”