Aspirin Versus LMWH for Thromboprophylaxis Following Hip or Knee Arthroplasty—Clinical Implications and Budget Impact
Article Swipe
Eugen Javor
,
Andrej Belančić
,
Patrik Javor
,
Goran Hauser
,
Ivan Kruljac
,
Marko Skelin
,
Andrea Katrin Faour
,
Marko Lucijanić
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/prp2.70147
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/prp2.70147
Venous thromboembolism (VTE) remains a significant concern for patients undergoing hip or knee arthroplasty, with a need to balance effective thromboprophylaxis and bleeding risk. We aimed to compare the efficacy, safety, and budget impact of aspirin versus low‐molecular‐weight heparin (LMWH) as sole thromboprophylactic agents initiated immediately postoperatively in this population. First, we conducted a systematic review of randomized controlled trials (RCTs) from Ovid MEDLINE, Embase, and Cochrane CENTRAL databases, assessing clinical outcomes and healthcare costs. Subsequently, a simplified budget impact analysis was performed using data from the largest identified and most recent RCT (CRISTAL trial) and its secondary analyses. Primary outcomes included symptomatic VTE, bleeding events, and reoperation rates. Through a systematic search, seven RCTs were considered to be eligible, with the CRISTAL trial providing the most compelling evidence. Aspirin was non‐inferior to LMWH for all‐cause mortality but was associated with a significantly higher symptomatic VTE rate (3,27% vs. 1,76%) and deep vein thrombosis (DVT), predominantly distal DVT. The budget impact analysis revealed that despite aspirin's lower per tablet cost, thromboprophylaxis with LMWH led to annual savings of $35,912,459 to $110,431,241 for U.S. healthcare stakeholders, and $17,075 to $56,450 for single hospitals performing 1000 arthroplasty procedures annually. To conclude, enoxaparin appears to offer superior clinical efficacy and cost‐effectiveness compared to aspirin for thromboprophylaxis following hip and knee arthroplasty. These findings support the preferential use of LMWH in this setting, while highlighting the need for further investigation into the clinical significance of aspirin's higher distal DVT and pulmonary embolism risk.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1002/prp2.70147
- OA Status
- gold
- References
- 41
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4412094679
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4412094679Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/prp2.70147Digital Object Identifier
- Title
-
Aspirin Versus
LMWH for Thromboprophylaxis Following Hip or Knee Arthroplasty—Clinical Implications and Budget ImpactWork title - Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-07-07Full publication date if available
- Authors
-
Eugen Javor, Andrej Belančić, Patrik Javor, Goran Hauser, Ivan Kruljac, Marko Skelin, Andrea Katrin Faour, Marko LucijanićList of authors in order
- Landing page
-
https://doi.org/10.1002/prp2.70147Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1002/prp2.70147Direct OA link when available
- Concepts
-
Medicine, Aspirin, Arthroplasty, Randomized controlled trial, Deep vein, Low molecular weight heparin, Population, Clinical trial, Systematic review, Thrombosis, Venous thromboembolism, Surgery, MEDLINE, Physical therapy, Internal medicine, Environmental health, Political science, LawTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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41Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.Primary | 100 |
| abstract_inverted_index.Through | 110 |
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| abstract_inverted_index.undergoing | 10 |
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| cited_by_percentile_year | |
| countries_distinct_count | 2 |
| institutions_distinct_count | 8 |
| citation_normalized_percentile.value | 0.45609862 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |