Abstract:

BACKGROUND: As an oral anticoagulant drug, many experiments have proved that rivaroxaban can prevent the deep venous thromboembolism after the hip arthroplasty. The foreign literatures indicate that it can significantly reduce the incidence of deep venous thromboembolism after extending the treatment course to 35 days. But there is no significant conclusion at home, and the safety of drugs after extentding the course has not been confirmed.
OBJECTIVE: To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin for the prevention of deep venous thrombosis after the hip arthroplasty.
METHODS: 106 patients with primary unilateral hip arthroplasty in the Second Clinical Medical College of Shanxi Medical University between March 2011 and September 2012 were selected. The patients were randomly divided into rivaroxaban group and low-molecular-weight heparin group. The patients in two groups were given drugs at 6 hours after replacement, the patients in the rivaroxaban group were given rivaroxaban 10 mg/d with the course of 5 weeks; the patients in the low-molecular-weight heparin group were given low-molecular-weight heparin 4 100 U/d with the course of 2 weeks.
RESULTS AND CONCLUSION: The review and follow-up results showed there was no deep vein thrombosis or symptoms of deep vein thrombosis in patients of the rivaroxaban group after replacement, while seven cases (13%) of deep vein thrombosis were observed in the low-molecular-weight heparin group, and there was significant difference in the incidence rate of deep vein thrombosis between two groups (P < 0.05). There were no significant differences in venous blood hemoglobin level, platelet level and coagulation function before and after replacement, as well as the drainage volume and subcutaneous ecchymosis area after replacement of the patients received unilateral hip arthroplasty between two groups (P > 0.05). The results indicate that full course of rivaroxaban has clear effect and reliable security in the prevention of deep venous thrombosis after hip arthroplasty.

Key words: bone and joint implants, artificial prosthesis, deep vein thrombosis, hip replacement, rivaroxaban, efficacy, safety, heparin