Safety and Efficacy of Aspirin in Thromboprophylaxis After Total Hip Arthroplasty: A Retrospective Study

Document Type : RESEARCH PAPER

Authors

1 1 Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran -Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

3 Orthopedic Surgery Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

6 Orthopedic Surgery Research Center, Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran

10.22038/abjs.2025.71614.3346

Abstract

Objectives: This study aimed to evaluate the safety and efficacy of aspirin as a standalone thromboprophylaxis (TP) treatment following elective total hip arthroplasty (THA). Additionally, it compares the primary and secondary outcomes related to efficacy and safety, respectively, between aspirin and enoxaparin.
Methods: A retrospective review was conducted of 2,107 patients who underwent primary or revision total hip arthroplasty (THA) between 2011 and 2017. Low-risk patients received aspirin (325 mg twice daily for 4 weeks), while high-risk patients were administered enoxaparin (4,000 units once daily for 2 weeks). The outcomes assessed included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE), hematoma, bleeding, infection, and 90-day mortality.
Results: The incidence of symptomatic deep vein thrombosis (DVT) requiring treatment in the aspirin group was 0.10% (2/1,905), whereas no cases were observed in the enoxaparin group. The rate of fatal pulmonary embolism (PE) was 0.05% (1/1,905) in the aspirin group, compared to 0.49% (1/202) in the enoxaparin group. Gastrointestinal (GI) bleeding occurred in 0.05% (1/1,905) of the aspirin group and 0.49% (1/202) of the enoxaparin group. The incidence of periprosthetic joint infection (PJI) was 0.15% (3/1,905) in the aspirin group, compared to 0.49% (1/202) in the enoxaparin group.
Conclusion: As a standalone TP agent, aspirin is at least as effective as potent anticoagulants for patients undergoing elective THA, with comparable safety and efficacy profiles.
        Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 13, Issue 11
November 2025
Pages 720-725

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History

  • Receive Date: 21 May 2023
  • Revise Date: 27 May 2025
  • Accept Date: 26 February 2025

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