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Research

COMPARABLE BLOOD LOSS AFTER THA WITH DABIGATRAN, ENOXAPARIN AND RIVAROXABAN

European Orthopaedic Research Society (EORS) 2015, Annual Conference, 2–4 September 2015. Part 1.



Abstract

Background

Hitherto, no study has compared blood loss (BL) after different thromoprophylactic regimes (TR). The objective of this study was to quantify and compare BL in total hip arthroplasty (THA) under three different TRs.

Methods

Between September 2013 and July 2014, sixty primary, unilateral, same-implant THAs entered a randomised, double-blind clinical trial. The patients were randomised to receive manufacturers' recommended doses of enoxaparin, dabigatran or rivaroxaban. Complete blood counts were obtained preoperatively and on the third day postoperatively. BL was calculated according to the Nadler formula. We also evaluated the occurence of wound healing disturbances (WHDs). All data were analysed using R statistical software.

Results

The mean BL and standard deviations were 844 ± 222 ml for enoxaparin, 854 ± 205 ml for dabigatran and 806 ± 227 ml for rivaroxaban. The BL did not significantly differ between groups (Kruskall-Wallis, p=0.92). More WHDs occured in the rivaroxaban group (5/20), compared to enoxaparin (2/20) and dabigatran (3/20).

Conclusions

None of the chemical TR is superior to others in terms of reducing the BL. There seems to be more WHDs with the use of oral agents - this finding needs further studies.

Level of evidence

1b (Centre for Evidence Based Medicine, Oxford)

Approval

This study was approved by The Medical Centre of Postgraduate Education Ethical Committee.

Disclosure

The authors disclose no competing interests