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Patients will be mobilized early after surgery, following a standardized enhanced recovery protocol. After an initial open-label prophylactic anticoagulation as per local standard of care until day 2 after surgery, treatment with rivaroxaban (10\u00a0mg once daily) will be started on day 3 and continued until day 10. Subsequently, patients will be switched to placebo in the experimental arm, or continue on active drug in the control arm, until a total of 35\u00a0days. The primary endpoint is acute symptomatic or fatal VTE within 3\u00a0months. A sample size of 2,932 patients will provide\u2009\u2265\u200980% power to reject the null hypothesis that \u03b4\u2009\u2265\u20090.01 (\u03b4\u2009=\u2009difference between the two arms in symptomatic VTE probability) at a significance level \u03b1\u2009=\u20090.05. An interim analysis will be performed after 3-month follow-up of the first 1,760 randomized patients at a significance level \u03b1\u2009=\u20090.50, leading to stop for futility if significance is not obtained, or if recalculation yields a sample size of\u2009&gt;\u20093,200 patients. ENABLE-Hip will be the first major randomized trial to test an overall reduction in the duration of post-THA thromboprophylaxis and will inform future guideline recommendations concerning this continuously growing patient population.<\/jats:p>\n          <jats:p>\n            <jats:bold>Trial registration:<\/jats:bold> ClinicalTrials.gov Identifier: NCT06611319<\/jats:p>\n          <jats:p>\n            <jats:bold>Graphical Abstract<\/jats:bold>\n          <\/jats:p>\n          <jats:p>Flow diagram of the ENABLE-Hip trial (ClinicalTrials.gov Identifier: NCT06611319).<\/jats:p>\n          <jats:p>ERAS: enhanced recovery after surgery; <jats:italic>o.d<\/jats:italic>.: <jats:italic>omni die<\/jats:italic> (once daily).<\/jats:p>","DOI":"10.1007\/s11239-025-03110-5","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T18:25:09Z","timestamp":1748543109000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhanced recovery and abbreviated length of anticoagulation for thromboprophylaxis after primary hip arthroplasty rationale and design of the ENABLE-hip 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LH reports lecture\/consultancy fees from Boston Scientific, INARI Medical, MSD and Johnson & Johnson, outside the submitted work. WA has participated in advisory boards for Astra Zeneca, Bayer, BMS-Pfizer, Leo Pharma, Norgine, Sanofi and Viatris. ELG has received speaker honoraria or consultancy fees from AstraZeneca, Bayer, Bristol-Myers Squibb, Pfizer, Organon, Lundbeck Pharma and Novo Nordisk. He is investigator in studies sponsored by AstraZeneca, Idorsia and Bayer, and has received unrestricted research grants from Boehringer Ingelheim. IML has relationships with drug companies including AOP-Health, Actelion-Janssen, MSD, United Therapeutics, Pulnovo, Medtronic, NovoNordisk and Daiichi. In addition to being investigator in trials involving these companies, relationships include consultancy service, research grants, and membership of scientific advisory boards. FC reports having received research grant support from Bayer, Bristol-Myers Squibb\/Pfizer, Merck Sharp and Dohme and fees for board memberships or symposia from Bayer, Bristol-Myers Squibb\/Pfizer, Merck Sharp and Dohme, GlaxoSmithKline, Chiesi and Astra Zeneca and having received travel support from Bayer, Bristol-Myers Squibb\/Pfizer, Merck Sharp and Dohme, Leo Pharma, Sanofi and Chiesi. RB reports research support by the Bavarian State Ministry of Health, FADOI (Federazione delle Associazioni dei Dirigenti Ospedalieri Internisti), VIATRIS and personal fees from Bayer, Bristol Myers Squibb, LEO Pharma, Pfizer, VIATRIS outside the submitted work. SVK reports research grants or contracts to his institution from Bayer AG, Daiichi Sankyo, Boston Scientific Corp., Penumbra Inc., and Inari Medical; and personal consulting fees from Daiichi Sankyo, Boston Scientific Corp., Penumbra Inc. and Inari Medical, all outside the submitted work. All other authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}