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Low-molecular-weight heparin followed by rivaroxaban or not for the prevention of deep venous thromboembolism after total knee arthroplasty

Zhou, Jiana,b; Fang, Ruia; Yan, Qianc; Li, Chenxid; Zhou, Yanlina; Nur, Ayub Abdullea; Liu, Tanga; Wang, Wanchuna

Blood Coagulation & Fibrinolysis: January 2019 - Volume 30 - Issue 1 - p 29–33
doi: 10.1097/MBC.0000000000000786
ORIGINAL ARTICLES
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To observe the effect of LMWH followed by rivaroxaban for the prevention of DVT after TKA. Between June 2015 and November 2017 as well as in accordance with the inclusion criteria, 118 patients undergoing TKA were randomly allocated to two groups. Patients in group A were applied LMWH, whereas patients in group B received LMWH followed by rivaroxaban postoperatively. The two groups were foIlowed up and compared for the incidence of DVT by color Doppler ultrasonography scan. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), Hb and D-Dimer were also compared. No statistically significant differences of ESR, CRP, and Hb was found between the two groups (P > 0.05), while higher levels of ALB and D-D in postoperation were observed in group B (ALB: 7 and 10 days after operation, D-D: 4, 7 and 10 days after operation). The overall DVT rate of group B (46.67%) is significantly higher than that of A (25.86%; P = 0.019, η = 0.216). Moreover, the occurrence rate of DVT in group A was 18.75% (3/16) and in group B is 16.67% (3/18) (P = 0.0445, η = 0.027) for men. The DVT rate of group A and B was 28.57 and 59.52%, respectively, with statistical difference (P = 0.002, η = 0.312) for female. The DVT rate of LMWH followed by rivaroxaban group is significantly higher than that of LMWH group, especially in female group, so it is not recommend to take rivaroxaban following injection of LMWH for the prevention of DVT after TKA.

aDepartment of Orthopedics, The Second Xiangya Hospital

bDepartment of Sports Medicine Research Center

cDepartment of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan

dDepartment of Clinical Medicine, School of Medicine, Shandong University, Jinan, Shandong, China

Correspondence to Profs. Tang Liu, and Wanchun Wang, MD, PhD, Department of Orthopedics, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011, China Tel: +86 731 85295128; fax: +86 731 85295128; e-mail: liutang1204@csu.edu.cn;wanchun.wang@csu.edu.cn

Received 29 May, 2018

Accepted 23 October, 2018

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