Rivaroxaban Use for Thrombosis Prophylaxis Is Associated With Early Periprosthetic Joint Infection

Brimmo, Olubusola; Glenn, Margaret K.; Klika, Alison K.; Murray, Trevor G.; Molloy, Robert

doi:10.1016/j.arth.2015.12.027

Cited by 37 publications

(34 citation statements)

References 26 publications

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“…However, the importance of the PAR1 and PAR2 signaling pathway might be only applicable for an initial viral infection or in immunocompromised individuals. Importantly, there are conflicting data about if the FXa inhibitor rivaroxaban increases the occurrence of early periprosthetic joint infections . A recent meta‐analysis for the risk of infection with new oral anticoagulants did not to find any association .…”

Section: Resultsmentioning

confidence: 99%

The coagulation system in host defense

Antoniak

2018

Research and Practice in Thrombosis and Haemostasis

159

109

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The blood coagulation system and immune system of higher organisms are thought to have a common ancestral origin. During infections, the blood coagulation system is activated and components of the hemostatic system are directly involved in the immune response and immune system modulations. The current view is that the activation of coagulation is beneficial for infections with bacteria and viruses. It limits pathogen dissemination and supports pathogen killing and tissue repair. On the other hand, over‐activation can lead to thrombosis with subsequent depletion of hemostatic factors and secondary bleeding. This review will summarize the current knowledge on blood coagulation and pathogen infection with focus on most recent studies of the role of the different parts of the blood coagulation system in selected bacterial and viral infections.

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Section: Resultsmentioning

confidence: 99%

The coagulation system in host defense

Antoniak

2018

Research and Practice in Thrombosis and Haemostasis

159

109

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“…при сравнении с надропарином натрия предложенная методика позволила сократить объем общей кровопотери более чем на 40% [29]. однако в ряде других публикаций авторы от-мечают на фоне приема ривароксабана более вы-сокую частоту послеоперационных кровотече-ний и большее количество осложнений в области послеоперационной раны, таких как гематомы, расхождение краев раны, поверхностная и даже перипротезная инфекции, что в ряде случаев при-водит к необходимости ревизионного вмешатель-ства [30]. В 2013 г. были проанализированы ре-зультаты применения ривароксабана после Тэп коленного сустава в университетской больнице уэльса.…”

Section: таблица 2/unclassified

Do We Know All About Prevention of Venous Thromboembolism After Major Orthopedic Surgery?

Божкова¹,

Касимова²,

Накопия³

et al. 2018

Traumatology and Orthopedics of Russia

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Venous thromboembolic events including deep venous thrombosis of lower limbs, tromboembolia of the pulmonary artery as well as non-symptomatic venous thromboembolic events are identified via venography and are considered to be potentially life-threatening implications after such major surgeries as total hip and knee arthroplasty. The need for tromboprophylaxis is well realized at present, and there is a wide range of medications with the indication of post-surgical prophylaxis of venous thromboembolic events.In this report the attempt has been made to carry out the comparative analysis of various currently used functional national guidelines on prophylaxis of venous thromboembolic events after total hip and knee arthroplasty. Moreover, having done the research in the systems PubMed (http://www.ncbi.nlm.nih.gov/pubmed, 2007–2017 гг.) and eLIBRARY (http://elibrary.ru, 2007–2017 гг.) the data of the last 10 years of experience in administration of oral anticoagulants has been collected and thoroughly analyzed (dabigatran etexilat, rivaroxaban, apixaban) and antiaggregant (acetylsalicylic acid) in clinical practice, besides comparative data has been also collected based on results obtained from laboratory control of anticoagulative effect of thrombin and x-factor direct inhibitors, even though the opportunities that laboratory control can provide are so far highly limited.At present the efficacy of pharmacological prophylaxis of venous thromboembolic events after total hip and knee arthroplasty is absolutely proven, and the issues concerning the safety of anticoagulants administration are the main focus. These issues frequently require personalized approach to selection of medication for tromboprophylaxis in accordance with the patient’s characteristics and the type of surgery chosen. All these aspects should become the focus for further research.

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“…Among these oral drugs, rivaroxaban demonstrated the most effective protection against DVT [ 12 ]. However, studies have shown higher incidences of wound bleeding and deep surgical site infection [ 13 , 14 ] in patient groups who were given rivaroxaban after TKA.…”

Section: Introductionmentioning

confidence: 99%

Combined use of topical intraarticular tranexamic acid and rivaroxaban in total knee arthroplasty safely reduces blood loss, transfusion rates, and wound complications without increasing the risk of thrombosis

Kim

Kang

Lee

et al. 2018

BMC Musculoskelet Disord

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BackgroundBlood loss and deep vein thrombosis (DVT) are important complications after total knee arthroplasty (TKA). Topical tranexamic acid (TXA) effectively reduces wound bleeding but may elevate the risk of DVT. In contrast, rivaroxaban potently prevents DVT but has been associated with bleeding complications. The simultaneous use of topical TXA and rivaroxaban in TKA has not been much investigated.MethodsA retrospective cohort study was conducted with two consecutive groups of patients who underwent TKA. Intraoperatively, one group (RVTX group) received topical, intraarticular TXA, while the other (RV group) did not. Both groups were administered rivaroxaban postoperatively for 14 days and underwent Doppler ultrasound for DVT screening. After propensity score matching, both groups consisted of 52 patients (104 patients in total) and were compared regarding total drain output, nadir haemoglobin (Hb), maximum Hb decrease, calculated total blood loss, transfusion rate, and incidence of DVT and wound complications.ResultsBoth groups showed no significant differences in the propensity-matched variables of age, sex, body mass index, American Society of Anesthesiologists physical status score, and preoperative Hb. The RVTX group showed a significantly higher nadir Hb (p < 0.001), lower drain output (p < 0.001), Hb decrease (p = 0.015), total blood loss (p < 0.001), and rate of transfusion (p < 0.001) and fewer wound complications (p = 0.027). However, the incidence of DVT (p = 1.000) did not differ significantly between the two groups, and all cases were asymptomatic.ConclusionsThe combined use of intraarticular topical TXA with rivaroxaban in patients undergoing TKA is a safe and effective method to reduce blood loss, the need for transfusion, and wound complications without elevating the risk of DVT.

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Rivaroxaban Use for Thrombosis Prophylaxis Is Associated With Early Periprosthetic Joint Infection

Cited by 37 publications

References 26 publications

The coagulation system in host defense

The coagulation system in host defense

Do We Know All About Prevention of Venous Thromboembolism After Major Orthopedic Surgery?

Combined use of topical intraarticular tranexamic acid and rivaroxaban in total knee arthroplasty safely reduces blood loss, transfusion rates, and wound complications without increasing the risk of thrombosis

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