VTE Prophylaxis in patients undergoing THA: Aspirin is enough

Backhrounds Both ACCP and AAOS guidelines approved aspirin as a safe and efficientchemoprophylaxis for VTE in patients undergoing THA. We conceive this study to see theefficiency and safety of aspirin in our THA patients.Methods In a Prospective series of consecutive 2145 THA patients between January 2011to January 2017 we used Aspirin as the only prophylaxis regimen against VTE. Patientswith major risk factors for VTE were excluded. There was no mechanical prophylaxis atour patients except early ambulation of patients with weight bearing as tolerated on sameday of surgery or the day after surgery. Hemoglobin (Hb) concentration preoperatively andpostoperative day(POD) 1 and 3 were calculated as an indicator of blood loss. All operationsexcept 256 were done through direct anterior approach. Routinely we use no suction drainin our patientsResults There are 5 cases (%0.002) of clinically symptomatic VTE. Two patients were diedwith probable diagnosis of PE one of them receiving low molecular weight heparin for VTEprophylaxis. No hematoma formation requiring surgical drainage observed in our patients.One patient with gastrointestinal bleeding requires admission. There were 18 patientswith wound drainage on POD 1 to 3 requiring dressing change. Mean Hb concentrationreduction were 2g/L (4-1g/L) and no patient required blood transfusionConclusions Considering enormous potential of aspiring in reduction of symptomatic VTEas recommended by AAOS and ACCP guidelines and in light of very low cost of aspirin werecommend routine use of aspirin as 1st line chemoprophylaxis against VTE in patientsundergoing THA. We still recommend more potent anticoagulants for patients with highprobability of VTE