Abstract

Purpose: The purpose of this study was determining the risk of hemarthrosis associated with prophylactic administration of rivaroxaban and enoxaparin in an ambulatory postoperative sports medicine patient population after knee arthroscopic procedures.

Methods: A retrospective observational chart review was performed for 214 patients [aged 16 to 53] who underwent arthroscopic knee surgery performed at a single surgical center between November 2011 and December 2016 and received postoperative VTE chemoprophylaxis. All patients were prescribed postoperative thromboprophylaxis with either rivaroxaban (dosed 10 mg orally every 24 hours for ten days) or enoxaparin (dosed 40mg subcutaneously every 24 hours for ten days). These patients were followed for a minimum three-month period post-operatively. All patients were evaluated at two and six weeks postoperatively and joint aspiration was performed if patients presented with painful and clinically significant knee swelling/effusion (grade 2+ to 3+) and/or limited range of motion. Deep vein thrombosis was ruled out by Doppler ultrasound if clinically suspected. Patients were excluded if age was less than 16 years or were not prescribed postoperative thromboprophylactic medication.

Results: Our data revealed that while there was no incidence of DVT in either group, 12.5% of patients in the rivaroxaban cohort were found to have clinically significant hemarthrosis versus 1.6% of patients in the enoxaparin group (Odds Ratio 8.9; CI 1.912 - 41.034, p-value = 0.0053).

Conclusion: If a surgeon chooses to prescribe chemoprophylaxis for ambulatory postoperative sports medicine patients, this study supports consideration of avoiding rivaroxaban, given the higher risk of a symptomatic hemarthrosis in the early postoperative period.

Keywords: Arthroscopic Knee; Hemarthrosis; Sports Medicine; Thromboprophylaxis; Venous Thromboembolism

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Citation

Citation: Brian P Davis., et al. “Hemarthrosis Resulting from Venous Thromboembolism Prophylaxis in the Postoperative Ambulatory Orthopedic Sports Medicine Patient: A Retrospective Study of Rivaroxaban Versus Enoxaparin".Acta Scientific Orthopaedics 4.11 (2021): .

Copyright

Copyright: © 2021 Brian P Davis., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.