Abstract | BACKGROUND: METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015. For 4 weeks, 3,192 patients received enteric-coated 325-mg aspirin twice daily (the 325-mg aspirin group) and 1,459 patients received 81-mg aspirin twice daily (the 81-mg aspirin group). There were no significant differences (p > 0.05) in sex, body mass index, or Charlson Comorbidity Index between the two patient populations. Recorded complications occurring within 90 days postoperatively included symptomatic venous thromboembolism ( deep venous thrombosis and pulmonary embolism), gastrointestinal complications, acute periprosthetic joint infection, and death. RESULTS: The incidence of venous thromboembolism of 0.1% (95% confidence interval [CI], 0% to 0.3%) in the 81-mg aspirin group (1 with deep venous thrombosis and 1 with pulmonary embolism) was not significantly different (p = 0.345) from 0.3% (95% CI, 0.1% to 0.6%) in the 325-mg aspirin group (7 with deep venous thrombosis and 5 with pulmonary embolism). The incidence of gastrointestinal bleeding or ulceration of 0.3% (95% CI, 0% to 0.5%) in the 81-mg aspirin group was slightly, but not significantly (p = 0.66), lower than the 0.4% (95% CI, 0.2% to 0.6%) in the 325-mg aspirin group. The incidence of acute periprosthetic joint infection was 0.2% (95% CI, 0% to 0.4%) in the 81-mg aspirin group compared with 0.5% (95% CI, 0.2% to 0.7%) in the 325-mg aspirin group (p = 0.28). The 90-day mortality rate was similar in both groups at 0.1% (95% CI, 0% to 0.2%) in the 81-mg aspirin group and 0.1% (95% CI, 0% to 0.2%) in the 325-mg aspirin group (p = 0.78). CONCLUSIONS: LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Authors | Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner |
Journal | The Journal of bone and joint surgery. American volume
(J Bone Joint Surg Am)
Vol. 99
Issue 2
Pg. 91-98
(Jan 18 2017)
ISSN: 1535-1386 [Electronic] United States |
PMID | 28099298
(Publication Type: Journal Article)
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Chemical References |
- Fibrinolytic Agents
- Aspirin
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Topics |
- Arthroplasty, Replacement, Hip
(adverse effects)
- Arthroplasty, Replacement, Knee
(adverse effects)
- Aspirin
(administration & dosage)
- Chemoprevention
- Cross-Over Studies
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Female
- Fibrinolytic Agents
(administration & dosage)
- Humans
- Male
- Middle Aged
- Postoperative Complications
(etiology, prevention & control)
- Prospective Studies
- Venous Thromboembolism
(etiology, prevention & control)
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