{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:26:37Z","timestamp":1792542397763,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":63,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Venous thromboembolisms (VTEs), including deep vein thrombosis (DVT) and pulmonary embolisms (PE), are common after total knee (TKA) and hip arthroplasty (THA). Recent studies suggest that aspirin effectively prevents VTE following major orthopaedic surgery. This meta\u2010analysis compares randomised controlled trials (RCTs) evaluating aspirin versus direct oral anticoagulants (DOACs) for VTE prevention after primary THA and TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included RCTs from 2017 to 2023 that looked at aspirin versus DOACs for VTE prophylaxis in primary THA and TKA. A search strategy was conducted which used Boolean operators and MESH terms. Primary outcomes included VTE rates, symptomatic, asymptomatic DVT and PE. Secondary outcomes were mortality and bleeding complications. Statistical analysis was performed using REVMAN software. An odds ratio with a 95% confidence interval was generated for the pooled studies. Heterogeneity was assessed using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      variable, and publication bias was evaluated with a funnel plot.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven RCTs with 3967 patients were included for analysis. Rivaroxaban 10\u2009mg OD was compared to varying doses of aspirin (81\u2013300\u2009mg). There were no significant differences between the groups in the incidence of VTE (OR: 1.21, 95% CI: 0.72\u20132.01), PE (OR: 1.01, 95% CI: 0.39\u20132.61), asymptomatic DVT (OR: 1.39, 95% CI: 0.64\u20133.00), suspected DVT (OR: 1.13, 95% CI: 0.49\u20132.61) and major bleeding (OR: 0.84, 95% CI: 0.55\u20131.27).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Aspirin is as effective as rivaroxaban for primary thromboprophylaxis post\u2010THA and TKA, without increased incidence of complications. Further research is needed to determine the optimal dosing regimen of aspirin and its long\u2010term efficacy in preventing VTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70010","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T04:35:33Z","timestamp":1725251733000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Comparative efficacy of aspirin versus direct oral anticoagulants for venous thromboembolism prophylaxis following primary total hip arthroplasty or total knee arthroplasty: A systematic review and meta\u2010analysis of randomised controlled trials"],"prefix":"10.1002","volume":"11","author":[{"given":"Fauzaan Ali","family":"Syed","sequence":"first","affiliation":[{"name":"Faculty of Health and Medicine, Lancaster University Medical School Lancaster University Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2287-381X","authenticated-orcid":false,"given":"Hamzah","family":"Amin","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine, Lancaster University Medical School Lancaster University Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biju","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery NHS Forth Valley Larbert Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery NHS Forth Valley Larbert Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Savaridas","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery NHS Forth Valley Larbert Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-021-02416-4"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1712746"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00004"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.10.017"},{"issue":"3","key":"e_1_2_13_6_1","first-page":"386","article-title":"Frequency and timing of clinical venous thromboembolism after major joint surgery","volume":"88","author":"Bj\u00f8rnar\u00e5 B.T.","year":"2006","journal-title":"The Journal of Bone and Joint Surgery. 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(2020)Patented medicines that have clinical benefits but not meet the EML Expert Review committee's comparative cost\u2010effectiveness criterion: case study on novel oral anticoagulants medicincespatentpool.org: medicines patent pool.https:\/\/medicinespatentpool.org\/uploads\/2020\/04\/Chapter-5-Patented-medicines-that-have-clinical-benefits-but-did-not-meet-the-EML-Expert-Review-committee%E2%80%99s-comparative-cost-effectiveness-criterion-Case-study-on-novel-oral-anticoagulants.pdf"},{"key":"e_1_2_13_22_1","unstructured":"National Institute for Health and Care Excellence. (2019)Venous thromboembolism in over 16s: reducing the risk of hospital\u2010acquired deep vein thrombosis or pulmonary embolism London 2018.https:\/\/www.nice.org.uk\/guidance\/ng89\/"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2205973"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060000"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01621.x"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000001305"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1913808"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0392-9590.19.04086-0"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2018.02.014"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.11.029"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-01-010645"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1693460"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/2309499019896024"},{"key":"e_1_2_13_34_1","first-page":"1093","article-title":"Effect of different types of anticoagulants in the prevention of venous thrombosis in the operation of knee joint bone operation","volume":"31","author":"Xu W.","year":"2018","journal-title":"Pakistan Journal of Pharmaceutical Sciences"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-06117-8"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:32:58Z","timestamp":1789489978000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/jeo2.70010"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70010","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70010"}}