Enteric-coated Aspirin can be an Effective Component of Multimodal Anticoagulation After Total Knee Arthroplasty

The role of aspirin as a prophylactic agent after total knee arthroplasty (TKA) remains controversial. We reviewed 1252 patients during a 5-year period undergoing TKA at a single center. Surgeries were done under regional anesthesia whenever possible. Patients with previous anticoagulation use or a history of deep venous thrombosis (DVT) or pulmonary embolism (PE) were excluded, but all others received the after anticoagulation protocol: shortened tourniquet times, early ambulation, TED stockings, SCDs and Aspirin 325 mg BID daily and for 6 weeks postoperative. Patients were only studied if they were clinically suspicious for DVT or PE. Sixteen such patients were studied. Two patients had superficial clots below the trifurcation. There were no proximal DVTs identified and no clinically evident PEs. No wound healing problems or hematomas required treatment. Gastritis developed in 2 patients who were treated with antacids. We concluded that aspirin, in addition to the aforementioned protocol, could provide adequate thromboprophylaxis among low-risk patients undergoing TKA.