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Basics: Aspirin after Knee Surgery
Newswise
— Taking aspirin to prevent blood clots
after knee surgery may be a safe and
effective alternative to currently
recommended treatments that are often
costlier and riskier, according to
preliminary results from a study presented
today at the 75th Annual Meeting of the
American Academy of Orthopaedic Surgeons (AAOS).
The study found that patients taking aspirin
had less risk of developing blood clots than
patients taking other blood-thinning drugs.
They also faced a similar risk compared to
patients receiving injectable drugs.
“Given the modern, less invasive techniques
that orthopaedic surgeons are using now for
total knee replacement, aspirin should be
reconsidered a viable alternative to
recommended therapies,” said Kevin J. Bozic,
MD, MBA.
Dr. Bozic is lead author on the study and
associate professor in residence at the
University of California, San Francisco
Department of Orthopaedic Surgery and Philip
R. Lee Institute for Health Policy Studies.
Currently, clinical practice guidelines for
preventing blood clots (venous
thromboembolism) after total knee
replacement do not recommend aspirin use.
This study suggests otherwise. Dr. Bozic and
his team compared data from more than 93,840
patients who underwent knee replacement
surgeries at some 300 hospitals between
October 2003 and September 2005. Researchers
compared the risk of:
• blood clots
• mortality
• surgical-site bleeding
• infection in patients receiving aspirin
versus guideline-approved therapies
The study found that aspirin patients had:
• fewer risk factors for blood clots prior
to surgery
• lower odds for blood clots compared to
patients on warfarin
• similar odds compared to patients
receiving injectable therapies to prevent
clots
• no difference in bleeding risks or
mortality
“Not only have surgical techniques changed,
but patients undergoing knee surgery today
are more likely to be younger and healthier
than when the current treatment guidelines
were developed,” said Dr. Bozic.
“Aspirin is a simple, inexpensive and
commonly used drug with few side effects, so
it’s a very attractive alternative.”
The study concludes that more research needs
to be conducted to help physicians determine
which patient characteristics and treatment
factors are best suited for aspirin use to
prevent blood clots in knee replacement
patients.
Most patients who undergo total knee
replacement are between the ages of 60 and
80, but orthopaedic surgeons evaluate
patients on an individual basis.
Recommendations
for surgery are based on a patient’s pain
and disability, not age.
Total knee replacements have been performed
successfully at all ages, from the teenager
with juvenile arthritis to the elderly
patient with degenerative arthritis. This
study shows significance as more than
533,000 knee replacements were performed in
2005.
Disclosure: Dr. Bozic and his co-authors
received research grants from the
Orthopaedic Research and Education
Foundation and California Healthcare
Foundation, and the Patient Safety Research
and Training Grant from the Agency for
Healthcare Research and Quality.
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