Study: Aspirin viable alternative to warfarin for healthy patients after TJA

Issue: December 25, 2012

Researchers at the Rothman Institute at Jefferson have found that the rate of pulmonary embolism was significantly lower for patients who received aspirin after total joint replacement compared with patients who received warfarin.

“While warfarin is successful in the prophylactic prevention of clots, it can also lead to increased bleeding, infections and hospital readmissions,” lead study author Javad Parvizi, MD, FRCS, director of research at the Rothman Institute at Jefferson in Philadelphia and Orthopedics Today Editorial Board member, stated in a press release.

Javad Parvizi

The investigators assessed 1,824 patients who received aspirin (325 mg twice daily) and 24,567 patients who received warfarin after joint replacement at their institution between 2000 and 2011. They reviewed the incidences of pulmonary embolism (PE) and bleeding or wound complications up to 90 days postoperatively. They matched patients for comorbidities and demographic variables using propensity scores.

The aspirin group had a significantly lower rate of PE at 0.2% than the warfarin group at 1%. There were no statistically significant differents between the groups for hematoma and seroma formation, wound problems, acute infections and 90-day mortality rates.

“Our study shows that aspirin is a viable alternative to warfarin in healthy patients, with better results in preventing clots, and a lower rate of bleeding and wound complications,” Parvizi stated in the release. “It will allow all of us to move away from expensive, inconvenient and dangerous drugs in the prevention of thromboembolism after joint replacement.”

Reference:

Parvizi J. Aspirin is an effective alternative for prevention of pulmonary embolism following joint arthroplasty. Presented at: American Association of Hip and Knee Surgeons; Nov. 2-4, 2012; Dallas.

Disclosure: Parvizi is a consultant to Zimmer, Smith and Nephew, 3M and Convatec.