By Adam Karalus, Physician Assistant Student at Daemen College, Writer and Contributor to Vein News and www.VeinsVeinsVeins.com
Patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) are at high risk of deep vein thrombosis (DVT) postoperatively, necessitating the use of measures to reduce DVT and venous thromboembolism.
Researchers utilized the Truven Health MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases for patients who recieved THA or TKA.
A total of 369,483 patients were included in the analysis from a research gropup headed by Harpreet Bawa and colleagues from the Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medicine and Biological Sciences, University of Chicago Medical Center, Chicago, IL.
Findings:
1) Warfarin was the most commonly prescribed anticoagulant in this study grup for patients who underwent surgery between 2004 and 2013.
2) Patients with a hypercoagulable diagnosis had markedly more DVT within 6 months after THA or TKA.
3) More patients with a hypercoagulable diagnosis were treated with warfarin or lovenox than other types of anticoagulants.
4) Patients prescribed aspirin, fondaparinux, and rivaroxaban were markedly less likely than those prescribed warfarin or enoxaparin to have a DVT within 6 months after THA or TKA.
Te study authors concluded thst the likelihood of DVT within 6 months of THA and TKA was markedly higher in patients treated with warfarin and lovenox and markedly lower in those treated with aspirin, fondaparinux, and rivaroxaban.
Full citation: Bawa H, Weick JW, Dirschl DR, Luu HH. Trends in deep vein thrombosis prophylaxis and deep vein thrombosis rates after total hip and knee arthroplasty. J Acad Orthop Surg 2018; 26: 698-705.