A large clinical trial published in the New England Journal of Medicine suggests that aspirin on its own works as well as a combination approach for preventing dangerous blood clots after joint replacement surgery.
The EPCAT III trial, published in the *New England Journal of Medicine*, looked at whether patients who have had a total hip or knee replacement (arthroplasty) need the blood-thinning drug rivaroxaban followed by aspirin, or whether aspirin alone is sufficient to prevent deep vein thrombosis (DVT) — blood clots that can form in the legs or lungs after major surgery.
Blood clot prevention is one of the central concerns after joint replacement. Surgery and reduced mobility in the days that follow raise the risk of clots forming, and current practice in many hospitals involves stronger anticoagulant (blood-thinning) drugs in the early recovery period. The EPCAT III findings challenge whether that more complex regimen is always necessary.
The journal also published an accompanying editorial — titled *Aspirin Therapy — Enough after Arthroplasty* — which weighs the clinical implications of the trial’s results.
The research was shared by the *New England Journal of Medicine* under the surgery and orthopaedics categories, signalling its relevance to surgical teams and the patients they treat.
Anyone who has recently had, or is planning, a hip or knee replacement and has questions about their blood clot prevention plan should speak to their surgical team or GP rather than changing any medication on their own. NHS 111 is available around the clock for health queries that can’t wait for a GP appointment.
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Key information
- Do not stop or change any prescribed medication without speaking to your GP or surgical team first.
- NHS 111 — call 111 or use the 111 online service for non-emergency health advice, 24 hours a day.
- In an emergency — call 999 if you experience sudden leg pain, swelling, chest pain or breathlessness after surgery.
Source: @NEJM