الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Total hip arthroplasty (THA) is one of the most successful orthopedic surgical procedures. In patients with degenerative hip joint cartilage pathologies, this technique offers significant pain relief, improved quality of life, and increased mobility in the medium- and long-terms. Aim of the Work: This study aims to review the acceptability of aspirin vs oral anticoagulant prophylaxis for reducing the risk of postoperative VTE in patients undergoing arthroplasty, The objective is to perform a systematic review of the outcomes of use of aspirin versus oral anticoagulant for prevention DVT after arthroplasty to assist the decision makers in selecting their treatment according to recommendations by the best available evidence. Patients and Methods: We included randomized controlled trials, prospective and comparative cohort studies, and nested case and control studies, and excluded cross-sectional studies, case series and case reports. The search results were uploaded to the Systematic Review Management program and manually checked for eligibility for inclusion. A PRISMA flowchart was produced based on search results and inclusion / exclusion criteria. Results: This systematic review demonstrated that there was no statistically significant difference in the risk of VTE (including DVT and PE) when comparing aspirin with other anticoagulants for VTE prophylaxis in patients undergoing THR and TKR. There were no differences in the risk of adverse events, such as bleeding, wound complications, myocardial infarction, and death, when aspirin was compared with other anticoagulants. Findings for adverse events were based on data reported by few studies, and some of the estimates were imprecise; therefore, caution is needed when interpreting these results. Conclusion: Our systematic review found that aspirin is a suitable therapy in the prevention of VTE in total hip and knee arthroplasty patients. However, we recognize that the evidence available demonstrates significant inconsistency in design and reporting, and thus, future prospective registry studies should be performed to optimize the dosing and duration regimen of aspirin. The degree of bleeding complications remains unclear on aspirin therapy, although the rate of major bleeding is low. |