The Study On The Effects Of Anticoagulant Therapy With Rivaroxaban And Apixaban For Perioperative On Primary Total Knee Arthroplasty

Objective To investigate the effects of anticoagulation therapy and complications with the low molecular weight heparin, rivaroxaban and apixaban on the primary total knee arthroplasty for perioperative.Methods 60 patients with osteoarthritis of the knee underwent primary total knee replacement surgery from April 2014 to September, randomized, namely low molecular weight heparin group, rivaroxaban group and apixaban group, 20 cases in each group. According to perioperative hematocrit calculated hidden blood loss; monitoring patients of three groups before surgery and 1,3,5 day in perioperative phase, the routine analysis of blood and the circumference change of the operative side of lower limbs on 10 cm up and 10 cm down patellar. Analysis of the three groups on the perioperative hidden blood loss, major bleeding events, non-serious bleeding, transfusion requirements, coagulation, and liver and kidney function, postoperative wound infection, deep vein thrombosis, pulmonary embolism and other influence.Results Hidden blood loss of three groups after surgery was 937.4 ± 308.7ml, 887.8 ± 311.4ml, 889.8 ± 296.9ml, no significant difference, P> 0.05. The three groups without thrombosis, hidden blood loss on circumference changes of lower limbs up and below patellar of the operated side correlated with statistical significance, P <0.05. The circumference average value of lower limbs up patellar in three groups was statistically significant, P <0.05. Deep vein thrombosis, pulmonary embolism, the incidence of complications was no significant difference in three groups, P> 0.05.Conclusion Patients undergoing primary total knee arthroplasty, respectively, used low molecular weight heparin, rivaroxaban and apixaban.Prophylactic anticoagulation are able to effectively prevent the occurrence of VTE, and no significant difference in the impact of postoperative complications.It is quite efficacy and safety. However, low molecular weight heparin with respect to rivaroxaban and apixaban increase the degree of the lower limbs swelling.