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



Khan FMY ; Razzaghof M ; Barzegar MR ; Shahpari O ; Abbaszadeh A ; Ghasemi MA ; Shafiei SH ; Mortazavi SMJ ; Khan FMY ; Barzegar MR ; Abbaszadeh A ; Ghasemi MA ; Shafiei SH
Source: Archives of Bone and Joint Surgery Published:2025

Abstract

Objectives: Thi s study ai med to eval uate the safet y and effi cacy of aspi ri n as a standal one thromboprophyl axi s (TP) treatment f ol l owi ng el ecti ve t otal hi p arthropl ast y (THA). Addi ti onal l y, i t compares the pri mary and secondary outcomes rel at ed to effi cacy and safet y, respecti vel y, between aspi ri n and enoxapari n. 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. © 2025, Mashhad University of Medical Sciences. All rights reserved.