Low-molecular-weight heparin versus rivaroxaban in orthopedic surgery

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Evaluation of: Beyer-Westendorf J, Lützner J, Donath L et al. Efficacy and safety of thromboprophylaxis with low-molecular-weight heparin or rivaroxaban in hip and knee replacement surgery. Findings from the ORTHO-TEP registry. Thromb. Haemost. 109(1), 154–163 (2013).

From the ORTHO-TEP registry on joint replacement arthroplasty (hip and knee) from Dresden, Germany, three periods of different prophylactic regimens have been compared. In the present paper, results from low-molecular-weight heparin and rivaroxaban have been analyzed, with rivaroxaban showing a benefit concerning both effect and side effects. Clinical end points are used, the results being in line with published data from randomized studies. Inclusion in the registry of consecutive patients is important to illustrate generalizability of results obtained in randomized trials. This review discusses the problem with using historical comparisons to draw firm conclusions.

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