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KMID : 1144520180300030247
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Knee Surgery & Related Research
2018 Volume.30 No. 3 p.247 ~ p.254
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Rivaroxaban and Acetylsalicylic Acid for Prevention of Venous Thromboembolism Following Total Knee Arthroplasty in Korean Patients
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Chung Kyu-Sung
Shin Tae-Yang
Park Sang-Hoon
Kim Hyuck
Choi Choong-Hyeok
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Abstract
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Purpose: To investigate the incidence of venous thromboembolism (VTE) after total knee arthroplasty (TKA) with chemoprophylaxis using acetylsalicylic acid (AA) or rivaroxaban in Korean patients.
Materials and Methods: Between May 2011 and November 2013, 268 TKA patients (330 cases) were randomly allocated to 3 groups (group A: subcutaneous injection of 5,000 IU low-molecular-weight heparin for 2 days followed by oral administration of 100 mg AA for 5 days; group X7: oral administration of 10mg rivaroxaban for 7 days; and group X10: oral administration of 10 mg rivaroxaban for 10 days). Multidetector-row computed tomography (MDCT) was performed at 10 days and 3 months postoperatively to evaluate VTE changes.
Results: The VTE incidence was 38.2%, 20.0%, and 10.0% in groups A, X7, and X10, respectively (p＜0.001). Pulmonary embolism (PE) was identified in 19.1%, 10.0%, and 2.7% in groups A, X7, and X10, respectively (p＜0.001). Proximal or symptomatic deep vein thrombosis (DVT) occurred primarily in group A, but the incidence was not significantly different among groups. On follow-up MDCT, PE was resolved completely with treatment in 29/30 (96.7%), and so was asymptomatic distal DVT in 24/27 (88.8%) without treatment.
Conclusions: Rivaroxaban had a lower incidence of overall VTE than AA, but no difference was observed in symptomatic VTE. The 10-day course of rivaroxaban had a lower incidence of overall VTE than the 7-day course.
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KEYWORD
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Knee, Arthroplasty, Venous thromboembolism, Rivaroxaban, Acetylsalicylic acid
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