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Aspirin Is As Effective As Low Molecular Weight Heparins in Preventing Symptomatic Venous Thromboembolism Following Arthroscopic Anterior Cruciate Ligament Reconstruction Publisher Pubmed



Yazdi H1 ; Eslami A1 ; Torkaman A1 ; Elahifar O1 ; Kasaeian A4 ; Alimoghadam S1 ; Alimoghadam R1 ; Abolghasemian M1
Authors
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Authors Affiliations
  1. 1. Bone and Joint Reconstruction Research Center, Department of Orthopedics
  2. 2. Department of Orthopedic, School of Medicine
  3. 3. Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran
  4. 4. Digestive Diseases Research Center, Digestive Diseases Research Institute
  5. 5. Research Center for Chronic Inflammatory Diseases
  6. 6. Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. University of Alberta, AB, Canada

Source: BMC Musculoskeletal Disorders Published:2024


Abstract

Objective: The optimal agent for thromboprophylaxis following arthroscopic anterior cruciate ligament reconstruction (ACLR) remains unclear, particularly in patients with a low baseline risk for venous thromboembolism (VTE). This retrospective cohort study aims to compare the effectiveness and safety of aspirin versus low molecular weight heparins (LMWHs) in this specific patient population. Methods: We analyzed data from patients who underwent ACLR between March 2016 and March 2021, focusing on those with a low risk for VTE. High-risk individuals, identified by factors such as cardiac disease, pulmonary disease, diabetes mellitus, previous VTE, inflammatory bowel disease, active cancer, and a BMI > 40, were excluded (n = 33). Our approach included a thorough review of medical charts, surgical reports, and pre-operative assessments, complemented by telephone follow-up conducted over a 3-month period by a single investigator. We assessed the incidence of symptomatic VTE, including deep vein thrombosis and pulmonary thromboembolism, as the primary outcome. The secondary outcomes included to complications related to the surgery and thromboprophylaxis. Statistical analysis included descriptive statistics, univariate logistic regression models, and calculations of incidence rates. Result: In our study, 761 patients (761 knees) were included, with 458 (60.18%) receiving aspirin and 303 (39.82%) receiving LMWH. The two groups showed no significant differences in demographic factors except for age. The incidence of VTE was reported at 1.31% (10 individuals). Specifically, five patients in the aspirin group (1.09%) and five patients in the LMWH group (1.65%) developed a symptomatic VTE event (p = 0.53). Additionally, the two groups did not significantly differ in terms of other complications, such as hemarthrosis or surgical site infection (p > 0.05). Logistic regression analysis revealed no statistically significant difference in VTE risk between the two groups. Conclusion: This study, focusing on isolated ACLR in patients with a low baseline risk for venous thromboembolism, demonstrated that aspirin is equally effective as low molecular weight heparins for VTE prophylaxis following this surgery. Level of Evidence: III. © The Author(s) 2024.