The Journal of arthroplasty · 2026
Aspirin Is Associated With Improved Thromboprophylaxis Versus Low-Molecular-Weight Heparin Following Revision Knee Arthroplasty for Periprosthetic Joint Infection.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wier Julian, Kumaran Pranit, Telang Sahil S, Culler Mckenzie W, Buchanan Connor, Lieberman Jay R, Heckmann Nathanael D
Аннотация
BACKGROUND: There is no consensus regarding the optimal venous thromboembolism (VTE) chemoprophylaxis agent following surgery for periprosthetic joint infection (PJI). Aspirin (ASA) and low-molecular-weight heparin (LMWH) are two commonly used agents; however, efficacy data in this population is lacking. This study compared ASA to LMWH among patients undergoing first-stage revision total knee arthroplasty for PJI.
METHODS: A large national database was queried from 2016 to 2023. Patients undergoing antibiotic spacer placement for a knee PJI were identified and divided into those who received either ASA or LMWH on postoperative day one. Patients taking other prophylactic agents or those who had a VTE history were excluded. Propensity score matching was used to balance cohorts. There were 10,472 patients 1:1 matched (5,236:5,236) based on VTE prophylaxis type and were well balanced for covariates (standardized mean difference < 0.10). Both cohorts had an average age of 66 years and an average Charlson comorbidity index of 3.2. Tranexamic acid was used in 61.2% of the ASA cohort and 60.3% of the LMWH cohort. To account for residual confounding, multivariable logistic regression models were used to assess our outcomes of VTE and postoperative transfusion.
RESULTS: The ASA patients had lower rates of VTE (1.0 versus 1.6%, P = 0.002; adjusted odds ratio = 0.6, 95% confidence interval = 0.4 to 0.9). Postoperative transfusion rates were significantly lower in the ASA cohort (6.0 versus 8.2%, P < 0.001; adjusted odds ratio = 0.8, 95% confidence interval = 0.6 to 0.9).
DISCUSSION: The use of ASA was associated with lower rates of VTE and transfusion compared to LMWH among patients who did not have a VTE history undergoing revision total knee arthroplasty for PJI. The use of ASA appears to be a safe and effective option for VTE chemoprophylaxis in this patient population.
METHODS: A large national database was queried from 2016 to 2023. Patients undergoing antibiotic spacer placement for a knee PJI were identified and divided into those who received either ASA or LMWH on postoperative day one. Patients taking other prophylactic agents or those who had a VTE history were excluded. Propensity score matching was used to balance cohorts. There were 10,472 patients 1:1 matched (5,236:5,236) based on VTE prophylaxis type and were well balanced for covariates (standardized mean difference < 0.10). Both cohorts had an average age of 66 years and an average Charlson comorbidity index of 3.2. Tranexamic acid was used in 61.2% of the ASA cohort and 60.3% of the LMWH cohort. To account for residual confounding, multivariable logistic regression models were used to assess our outcomes of VTE and postoperative transfusion.
RESULTS: The ASA patients had lower rates of VTE (1.0 versus 1.6%, P = 0.002; adjusted odds ratio = 0.6, 95% confidence interval = 0.4 to 0.9). Postoperative transfusion rates were significantly lower in the ASA cohort (6.0 versus 8.2%, P < 0.001; adjusted odds ratio = 0.8, 95% confidence interval = 0.6 to 0.9).
DISCUSSION: The use of ASA was associated with lower rates of VTE and transfusion compared to LMWH among patients who did not have a VTE history undergoing revision total knee arthroplasty for PJI. The use of ASA appears to be a safe and effective option for VTE chemoprophylaxis in this patient population.