Combination of enoxaparin and low-dose aspirin for thromboprophylaxis in selective patients after primary total joint arthroplasty in a Taiwanese population - Original article

Sep 29, 2026

Uploaded by Ezra

Background: Deep vein thrombosis (DVT) and pulmonary embolism (PE) rates after total joint arthroplasty (TJA) are lower in Asian populations than in Caucasian populations, leaving thromboprophylaxis needs in Asian patients inconclusive. Aim: Validate clinical outcomes of thromboprophylaxis in selective TJA patients in Taiwan. Methods: Retrospective single-surgeon review (2010–2019); selective enoxaparin plus low-dose aspirin based on defined risk criteria. Outcomes included DVT/PE, 90-day complications, readmission, and 1-year reoperation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Methods

J Chin MedAssoc Original article Combination of enoxaparin and low-dose aspirin for thromboprophylaxis in selective patients after primary total joint arthroplasty in a Taiwanese population Shang-Wen Tsaia,b, Wei-Lin Changa,b, Fu-Yuan Paia,b, Te-Feng Arthur Choua,b, Cheng-Fong Chena,b, Po-Kuei Wua,b, Wei-Ming Chena,b,* aDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDepartment of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC ABSTRACT Background: The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after total joint arthroplasty (TJA) procedures are lower in Asian populations than in Caucasian populations. Therefore, the need for thromboprophylaxis in Asian patients undergoing TJA remains inconclusive. The aim of this study was to validate the clinical outcomes of thromboprophylaxis in selective TJA patients in a Taiwanese population. Methods: We retrospectively reviewed records of patients who underwent TJA procedures performed by a single-surgeon between January 2010 through December 2019. Patients received thromboprophylaxis with a combination of enoxaparin and low-dose aspirin if they fulfilled any of the following criteria: 1) body mass index >30 (kg/m2), 2) presence of varicose veins, 3) history of DVTor PE, or 4) simultaneous bilateral TJA procedure. We assessed the incidence of DVT and PE, 90-day postoperative complications, length of stay, in-hospital mortality, 30-day and 90-day readmission, and 1-year reoperation. Results: Of the 7511 patients included in this study, 2295 (30 . 6%) patients received thromboprophylaxis. For patients who received thromboprophylaxis(N = 2295), the incidence of DVT and PE were 0.44% and 0%, respectively. For patients who did not receive thromboprophylaxis (N = 5216), the incidence of DVT and PE was 0.46% and 0.04%, respectively. The overall rates of 90-day postoperative complications (2 .3%), 30-day (1 . 8%) and 90-day readmission (2 .3%), and 1-year reoperation (1 . 1%) were low. Conclusion: Providing thromboprophylaxis for selective TJA patients within the Taiwanese population was effective, as indicated by the low incidence of DVT and PE. Complications, such as surgical site infection, should be carefully weighed and managed. Keywords: Aspirin; Deep vein thrombosis; Low molecular weight heparin; Pulmonary embolism; Total hip arthroplasty; Total knee arthroplasty 1. INTRODUCTION Patients undergoing elective total joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arthroplasty (THA), are at high risk of venous thromboembolism (VTE) .1–3 According to clinical practice guidelines from the American Academy of Orthopaedic Surgeons and the American College of Chest Physicians (ACCP), pharmacologic agents are * Address correspondence. Dr. Wei-Ming Chen, Department of Orthopaedicsand Traumatology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: wmchen2499.vghtpe@gmail. com (W.-M. Chen) Conflicts of interest: Dr. Wei-Ming Chen, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2023) 86: 923-929. Received August 13, 2022; accepted June 18, 2023. doi: 10. 1097/JCMA.0000000000000978 Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) recommended for every patient undergoing elective TJA whose bleeding risk is lower than the risk of developing VTE, including symptomatic deep vein

FAQs

What was the study’s primary goal in a Taiwanese population?

To validate clinical outcomes of thromboprophylaxis using enoxaparin plus low-dose aspirin in selected TJA patients in Taiwan.

Who received the thromboprophylaxis combination in this study?

Patients were given enoxaparin plus low-dose aspirin if they met at least one risk criterion: BMI > 30, varicose veins, history of DVT or PE, or simultaneous bilateral TJA.

What did the study report about DVT and PE incidence?

Among thromboprophylaxis recipients (N=2295), DVT incidence was 0.44% and PE incidence was 0%. Among non-recipients (N=5216), DVT was 0.46% and PE was 0.04%.

Sep 29, 2026

Uploaded by Ezra