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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 October;64(5):527-33
Rivaroxaban administration in hip and knee replacement surgery: clinical practice and safety profile
Salini V. 1, Pantalone A. 1, Vanni D. 1, Antinolfi P. 2 ✉
1 Clinica Ortopedica e Traumatologica, Università “G. d’Annunzio”, Chieti, Italia;
2 Clinica Ortopedica e Traumatologica, Università degli Studi di Perugia, Perugia, Italia
Aim: An observational study was carried out on patients undergoing hip or knee arthroplasty to describe the clinical practice impact of the time from surgery to first administration of rivaroxaban on safety and thromboembolic events.
Methods: All 18-year-old patients who underwent elective knee or hip arthroplasty between January 2011 and May 2012 at 12 Italian orthopedic centres and were given rivaroxaban for thromboprophylaxis were eligible. The following data were collected and analyzed descriptively: age, gender, body mass index, medical history, type of surgery and anesthesia, mode of administration of rivaroxaban (time of introduction after surgery and duration of treatment), time of mobilization, duration of hospital stay and follow-up, as well as occurrence of thromboembolism, bleeding and other adverse events.
Results: A total of 199 patients were included, 130 (65.3%) undergoing hip arthroplasty and 69 (34.7%) undergoing knee arthoplasty. The thromboembolism rate and the bleeding rate were both 0.5%; IC95% 0.09-2.79. Most patients received the first administration of rivaroxaban above 8 hours after surgery (79.3% of patients undergoing hip arthroplasty, 85.5% of patients undergoing knee arthroplasty).
Conclusion: This observational study supports the evidence that delaying the first administration of rivaroxaban until 8 hours or more is safe and does not increase the risk of thromboembolic events in patients undergoing hip or knee arthroplasty.