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To study the efficacy and safety of Rivaroxaban in the prevention of venous thromboembolism after Total Hip and Knee Arthroplasty

Vol 3 | Issue 2 | Sep-Dec 2017 | page: 3-7 | S. K. Rai, V. P. Raman, Naveen Shejale, S. S. Wani, Rohit Varma


Author: S. K. Rai [1], V. P. Raman [2], Naveen Shejale[3], S. S. Wani [1], Rohit Varma [1].

[1]Department of Orthopaedics, Indian Naval Hospital Ship Asvini, Colaba, Mumbai, 400005, India.
[2]Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, 500055, India.
[3]Department of Orthopaedics, Indian Naval Hospital Ship Kalyani, Visakhapatnam, 530005, India.

Address of Correspondence
Dr. SK Rai
Department of Orthopaedics, Indian Naval Hospital Ship Asvini, Colaba, Mumbai, 400005, India.
Email: skrai47@yahoo.com


Learning Points for this Article: To prevent of venous thromboembolism after total Hip and Knee Arthroplasty there is parenteral low molecular weight heparin is available and being used in many centers but it has to be given my trained paramedic or nurse however oral drug like Rivaroxaban in once daily doses and it is patients friendly and can be taken at home after discharge. It is safe and as effective as parenteral low molecular weight heparin.


Abstract

Objective: Development of venous thrombo-embolism (VTE) including deep venous thrombosis (DVT) is a common complication after total hip and total knee Arthroplasty, pelvic fracture or long bone fractures especially in the lower limb. Currently used drugs for DVT prophylaxis after these procedures have important limitations, including parenteral administration, and unpredictable plasma levels requiring frequent monitoring and dose adjustment leading to decreased patient compliance. In our study we used oral rivaroxaban, which is one of the newer oral anticoagulants and is a direct factor Xa inhibitor that has demonstrated superior efficacy, compared to that of enoxaparin or any parenteral low molecular weight heparin (LMWH).
Materials and Methods: In our study, 180 patients who underwent Total knee replacement (TKR) or Total hip replacement (THR) in our center were included. They were put on oral rivaroxaban, 10 mg once daily, started 6 h after surgery and continued for 3 weeks in case of TKR and 6 weeks in case of THR.
Results: VTE and DVT are common complications after THR and TKR and cause a substantial burden to patients, healthcare providers, increase costs to the patients and increase both morbidity and mortality, if not addressed promptly. Currently available anticoagulants in the form of subcutaneous injection have limitations that lead to decreased compliance with DVT prophylaxis guidelines. Rivaroxaban which is oral 10 mg once daily has superior efficacy compared to enoxaparin or any parenteral LMWH for the prevention of the same and the patient compliance is also very good. There were no incidences of increased bleeding or wound infection in our study as compared to control group which were given subcutaneous enoxaparin.
Keywords: Venous thrombo-embolism, deep vein thrombosis, Total knee replacement, Total hip replacement, Rivaroxaban, deep venous thrombosis prophylaxis.


References

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How to Cite this article: Rai S K, Raman V P, Shejale N, Wani S S, Varma R. To study the efficacy and safety of Rivaroxaban in the prevention of venous thromboembolism after Total Hip and Knee Arthroplasty. Trauma International Sep – Dec 2017;3(2):3-7.


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