Vascular Investigation and Therapy (Jul 2024)

Comparison of the therapeutic effect of different anticoagulation regimens after total hip arthroplasty based on enhanced recovery after surgery: A retrospective study

  • Dede Cao,
  • Heping Bai,
  • Muhammad Saad,
  • Jinfeng Ma,
  • Jiangjiang Zhang,
  • Shenglu Lei,
  • Yunwei Dong,
  • Dong Li,
  • Haoyu Wu,
  • Jianlin Liu

DOI
https://doi.org/10.4103/VIT.VIT_25_24
Journal volume & issue
Vol. 7, no. 2
pp. 21 – 27

Abstract

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This retrospective study investigated the efficacy and economic outcomes of low molecular weight heparin (LMWH), fondaparinux sodium (FPX), and rivaroxaban after total hip arthroplasty (THA) under Enhanced Recovery After Surgery (ERAS). The clinical data of patients who underwent primary THA due to hip joint disease in our Hospital from October 2020 to June 2022 were retrospectively collected and analyzed. According to different anticoagulant methods, patients were divided into LMWH group (42 cases), FPX group (24 cases), and Rivaroxaban group (39 cases). Perioperative blood coagulation-related factors, D-dimer, platelet (PLT) changes, blood routine, blood loss, lower limb vein thrombosis (DVT), pulmonary embolism, and allogeneic blood transfusion were compared among the three groups. There was no statistical significance difference for coagulation indexes and Visual Analog Scale score before the operation among the three groups, but there were statistical significance differences for prothrombin time and international normalized ratio levels at 3 days after the operation. The postoperative drainage volume and blood loss of the three groups were different, but there were no significant differences in intraoperative blood loss, hidden blood loss, total blood loss, blood transfusion rate, DVT incidence rate and Visual Analog Scale score score 3 days after surgery among the three groups. Besides, the treatment cost in the LMWH group was significantly lower than that of the FPX group and the rivaroxaban group. Hence, Based on the ERAS concept, the use of LMWH, FPX, and Rivaroxaban after THA can effectively and safely prevent the occurrence of VTE and has no significant difference in postoperative pain, perioperative blood loss, and coagulation function. However, Rivaroxaban can be taken orally and has more advantages in some pharmacological effects, while LMWH is cheaper.

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