Abstract
Introduction
Our department is responsible specifically for complex cases resulting from trauma. Our experience does not want to add what has been clearly demonstrated by multicenter studies on the efficacy of rivaroxaban but aims to demonstrate how the use of this molecule was effective also in mega-prosthesis and how it has proven to be flexible and safe in dealing with difficulties and surgical complications more common in such difficult cases.
Materials and Methods
From January 2010 to date DVT prophylaxis in THR / TKR and revision was routinely performed with rivaroxaban. To date, in addition to first implant/revision in THR/TKR we treated over 30 cases of large segments replacements (large segments+mega-prosthesis) and we have not highlighted complications attributable to rivaroxaban.
Discussion
We present in particular the medical and surgical management of three cases with a high risk of bleeding: a case of revision of total femur due to recurrent dislocation, one case of revision for early infection of a TKR and a case of traumatic acetabular revision for pelvicbreakthrough during rehabilitation.
Conclusion
The major practical advantages found are: 1) the ability to choose when to start prophylaxis in relation to intraoperative bleeding Vs therapy that begins the previous day, 2) seeking the best prophylaxis for primary prosthetic and complex cases, the single-dose and pharmaco-kinetics/dynamic of rivaroxaban guarantee to be able to easily switch to a traditional prophylaxis in case of a need for further surgey Vs multi-dose of other oral drugs.
