Safety and Efficacy of Aspirin in Thromboprophylaxis After Total Hip Arthroplasty: A Retrospective Study

Abstract

Objectives: This study aimed to evaluate the safety and efficacy of aspirin as a standalone thromboprophylaxis (TP) treatment following elective total hip arthroplasty (THA). Additionally, it compares the primary and secondary outcomes related to efficacy and safety, respectively, between aspirin and enoxaparin. Methods: A retrospective review was conducted of 2,107 patients who underwent primary or revision total hip arthroplasty (THA) between 2011 and 2017. Low-risk patients received aspirin (325 mg twice daily for 4 weeks), while high-risk patients were administered enoxaparin (4,000 units once daily for 2 weeks). The outcomes assessed included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE), hematoma, bleeding, infection, and 90-day mortality. Results: The incidence of symptomatic deep vein thrombosis (DVT) requiring treatment in the aspirin group was 0.10 (2/1,905), whereas no cases were observed in the enoxaparin group. The rate of fatal pulmonary embolism (PE) was 0.05 (1/1,905) in the aspirin group, compared to 0.49 (1/202) in the enoxaparin group. Gastrointestinal (GI) bleeding occurred in 0.05 (1/1,905) of the aspirin group and 0.49 (1/202) of the enoxaparin group. The incidence of periprosthetic joint infection (PJI) was 0.15 (3/1,905) in the aspirin group, compared to 0.49 (1/202) in the enoxaparin group. Conclusion: As a standalone TP agent, aspirin is at least as effective as potent anticoagulants for patients undergoing elective THA, with comparable safety and efficacy profiles. Level of evidence : IV