Anticoagulants after arthroplasty . . . and other stories

Preventing venous thromboembolism after arthroplasty

Venous thromboembolism is a well recognised risk after knee arthroplasty, but there’s no consensus on the best prophylaxis. A large retrospective register based analysis from Michigan reports that patients given aspirin alone fared no worse than those given non-aspirin anticoagulants or a combination of the two, and a great deal better than those who received no prophylaxis (JAMA Surg doi:10.1001/jamasurg.2018.3858). The problem here is that the various anticoagulants weren’t allocated at random and the lack of difference between them might be due to confounding by indication.