The comparison of enoxaparine sodium and rivoraxaban in the prophylaxis of the deep vein trombosis and pulmonary embolism in total hip and knee arthroplasty operations

Pulmonary thromboembolism that is secondary to deep vein thrombosis is one of the most serious early complications of arthroplasty. Prophylactic medical treatment is crucial in the prevention of this complication. This study aims to compare the efficacy of rivaroxaban, a new-generation anticoagulant, and enoxaparin, i.e. low-molecular-weight heparin, in preventing pulmonary thromboembolism. A total of 214 patients were included in the study, 166 (77.6%) of which were female and 48 (22.4%) were male. 178 subjects (83.2%) underwent total knee prosthesis, and 36 (16.8%) underwent total hip replacement. The patients were divided into 3 groups according to medical treatment: subcutaneous enoxaparin both during hospitalization and after discharge (group 1, n = 46, 21.5%); oral rivaroxaban both during hospitalization and after discharge (group 2, n = 123, 57.5%); sequential subcutaneous enoxaparin (during hospitalization) and oral rivaroxaban (after discharge) (group 3, n = 45, 21%). All subjects were provided with medication during the entire postoperative hospital stay and for 15 days after discharge. The mean age of the subjects was 65 ± 9.64 years (25-89). The mean length of hospital stay after the operation was 5.4 days (2-14), and the mean duration of operation was 102 minutes (90-135). The three groups of patients were evaluated for deep vein thrombosis, pulmonary embolism, and other major and minor complications. There were no cases of deep vein thrombosis or pulmonary embolism in any of the 214 subjects. Major complications were observed in 5 patients in Group 1 (n = 46), 15 patients in Group 2 (n = 123), and 6 patients in Group 3 (n = 45). Minor complications were observed in 10 patients in Group 1 (n = 46), 24 patients in Group 2 (n = 123), and 11 patients in Group 3 (n = 45). The three groups were not statistically different in any parameter. We conclude that rivaroxaban can be preferred as a less invasive alternative to enoxaparin due to their similar pulmonary embolism and deep vein thrombosis outcomes.