A Meta-analysis Of The Efficacy Of Rivaroxaban And Aspirin In Preventing Thrombosis After Hip And Knee Replacement

Objective(s):With the aging of the population,the number of patients with degenerative diseases of the hip and knee also increases.Total hip arthroplasty and total knee arthroplasty(THA/TKA)have been widely used in the clinical treatment of such patients and have achieved good efficacy.At the same time,Venous thromboembolism(VTE)is one of the most common complications after THA and TKA.Currently,aspirin,rivaroxaban,low molecular weight heparin calcium and other drugs and physical therapy are mainly used to prevent VTE.This study conducted multiple meta analysis of the literatures of rivaroxaban and aspirin for preventing VTE after hip and knee arthroplasty by searching multiple medical literature databases to provide a theoretical basis for the clinical prevention of venous thromboembolism.Methods:Literature retrieval was conducted on Pubmed,Embase,Cochrane library,cnki,wanfang database and meterstix,mainly including randomized controlled trials(RCTS)in English and Chinese comparing the efficacy of aspirin and rivaroxaban in the prevention of VTE formation after hip and knee arthroplasty.The primary outcome was the incidence of VTE after hip and knee arthroplasty,and the secondary outcome was the incidence of bleeding complications.According to the criteria,relevant literature was included and relevant information was extracted.Nine RCTS were retrieved,involving 4,374 patients.Among them,2192 cases were treated with rivaroxaban and 2182 with aspirin.Meta analysis was performed using Review Manager 5.3 on the premise of quality assessment by Cochrane and heterogeneity test by 12 statistics.Results:The results of meta-analysis showed that there was no significant difference in the incidence of VTE between the rivaroxaban group and the aspirin group after hip and knee arthroplasty[OR=0.66,95%CI(0.39,1.14),P>0.05].In another study,a comparison of bleeding complications was conducted,and the results showed no significant difference in the occurrence of postoperative bleeding complications between the two groups[OR=0.91,95%CI(0.52,1.60),P>0.05].Conclusion(s):There was no significant difference between rivaroxaban and aspirin in the prevention of VTE formation and bleeding complications after THA and TKA.