Rivaroxaban Versus Low Molecular Weight Heparin In Prevention Of Venous Thromboembolism In Patients Undergoing Hip Or Knee Arthroplasty

ObjectiveTo evaluate the efficacy and safety of Rivaroxaban versus low molecularweight heparin (LMWH) in prevention of venous thromboembolism (VTE) aftertotal hip or knee arthroplasty.MethodsFrom August,2009to July,2010,84patients were recruited in this study.Under randomization,48were assigned into the observation group ofRivaroxaban and36into the control group of LMWH. The observation grouphad13males and35females, including25cases of total hip arthroplasty (THA)and23cases of total knee arthroplasty (TKA). The control group had10malesand26females, including16cases of THA and20cases of TKA. OralRivaroxaban (10mg once per day) was administered for THA patients from day1to35postoperatively and for TKA patients from day1to14postoperatively. Hypodermic injection of LMWH (0.4ml once per day) was administered forTHA patients from day1to35postoperatively and for TKA patients from day1to14postoperatively.ResultsAll the patients were followed up for3months. The VTE rate was20.83%(10/48) in the observation group, and25.0％(9/36) in the control group. Thedifference between the2groups was insignificant (x2=0.204, P=0.651). Therewas no significant difference either in intraoperative between the2groups(P>0.05). No symptoms of pulmonary embolism were observed in either group.ConclusionThe clinical efficacy and safety of Rivaroxaban is comparable to LMWH inreducing the incidence of VTE after THA or TKA. Rivaroxaban is associatedwith low risks of hematomas, delayed wound healing, and postoperativeinfection.