Rivaroxaban versus low-molecular-weight heparin for prevention of deep venous thrombosis after primary total hip arthroplasty

Abstract

Objective To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin (LMWH) for prevention of deep venous thrombosis (DVT) after primary total hip arthroplasty(THA).Methods From January 2008 to April 2010,136 cases received in our department prophylactic DVT treatment with rivaroxaban or LMWH after unilateral primary THA.There were 68 patients in each group.The duration of LMWH prophylaxis was one week,and the durations of rivaroxaban prophylaxis were 2 weeks in 38 cases and 5 weeks in 30 cases.The levels of hemoglobin (Hb) and platelet (Plt),prothrombin time(PT),activated partial thromboplastin time (APTT),minor bleeding and major bleeding events were measured and compared between the LMWH and rivaroxaban groups.There was no significant difference between groups in the general data of the patients( P ＞ 0.05).Results There were no significant differences regarding the levels of Hb and Plt,PT and APTT between the 2 groups preoperation or postoperation ( P ＞ 0.05).The minor bleeding and major bleeding events were similar in 2 groups ( P ＞ 0.05).A significant difference in DVT incidence was found between the 2 groups,with 0％ in the rivaroxaban group and 7.4％ in the LMWH group( P ＜ 0.05).Conclusion Since rivaroxaban is more effective and reliable than LMWH in DVT prevention after primary total hip arthroplasty,intervention of sufficient duration is necessary. Key words: Venous thrombosis; Heparin, low molecular weight; Arthroplasty, replacement,hip; Rivaroxaban