Background

Comparative study between enoxaparin and acetylsalicylic acid in antithrombotic prophylaxis for patients undergoing elective total knee arthroplasty
There is still controversy regarding thrombo-prophylaxis for the reduction of thromboembolic disease in major orthopedic surgery.
Laying the groundwork for indicating pharmacological monotherapy, its dose and reproducibility is essential, so we ask the following question: is there a difference in the effectiveness and safety in antithrombotic management of patients with a traditional postsurgical enoxaparin regimen against acetylsalicylic acid?
Study Design & Methods
TKAs were performed by 3 surgeons, the sample was randomized and the patients were subjected to the study criteria.
We evaluated two main variables, efficacy, and safety, as the need for readmission, as well as secondary variables such as infection, myocardial infarction, stroke, and death with a 90-day follow-up.

Results

The total sample was 402 patients; 214 in the enoxaparin group and 188 in the aspirin group. Five cases (1.24%) with thromboembolic disease, 3 (1.4%) enoxaparin and 2 (1.06%) aspirin were presented without significant difference (p = 0.23). Regarding safety, major bleeding was zero in both groups, presenting minor bleeding in 7 patients (1.74%), 4 (1.86%) were from the enoxaparin group and 3 (1.59%) from the aspirin group without significant differences (p = 0.82).
Secondary results showed 5 (1.24%) superficial surgical wound infections and myocardial infarction in the first 30 days of the procedure in the enoxaparin group.

Conclusions

Aspirin as monotherapy is safe, effective, and reproducible in TKAs, being the starting point for the analysis in patients undergoing other major orthopedic surgeries and with risk factors.