ASPIRIN AND WARFARIN FOR THROMBOEMBOLIC DISEASE AFTER TOTAL JOINT ARTHROPLASTY

This study compares the benefits of aspirin and warfarin prophylactic agents for patients with thromboembolic disease after total joint arth roplasty. It is a prospective randomized study of 388 patients having total hip or total knee surgery, All consecutive patients having total hip or total knee surgery were entered into this study and evaluated with preoperative and postoperative ventilation perfusion scans and a postoperative venogram, The aspirin and warfarin treatment groups were compared by size and location of venographically revealed clots and c hanges in ventilation perfusion scans. The results showed that there w as no difference in the size or location of deep venous thrombosis in the aspirin or warfarin treatment groups, The venogram was negative in 44.5% of patients; 28.8% had small calf clots, 16% had large calf clo ts, 3.9% had popliteal clots, and 6.7% had femoral clots, Patients wit h total knee replacement had a 2.6 times greater incidence of calf dee p venous thrombosis than patients with total hip replacement, There wa s no difference between the aspirin and warfarin groups in the inciden ce of changes in ventilation perfusion scans (18.9%), There was no dif ference between the 2 groups in bleeding complications, The results su ggest that aspirin and warfarin are equivalent in prophylaxis against thromboembolic disease, as determined by prevention of venographic cha nges or changes in ventilation perfusion scans.