Is There a Role for Aspirin in Venous Thromboembolism Prophylaxis After Total Knee Replacement?

American College of Chest Physicians (ACCP) guidelines for venous thromboembolism prophylaxis (VTEP) after total knee arthroplasty (TKA) favor LMWH, pentasaccharides (Fondaparinux), and warfarin over aspirin. However, recent data suggest that ACCP recommended therapies may increase bleeding complications after TKA. To determine the risks and benefits of various VTEP strategies, we compared rates of DVT, PE, surgical site bleeding, and mortality in a large national population of patients who received aspirin, warfarin, LMWH, or Fondaparinux for VTEP after TKA.