While warfarin can be effective, research from the Rothman Institute at Jefferson has shown aspirin to be just as effective in preventing clots, specifically pulmonary emboli, following joint replacement surgery. Their research was recognized as one of the best poster presentations at the recent American Association of Hip and Knee Surgeons (AAHKS) meeting in Dallas. "While warfarin is successful in the prophylactic prevention of clots it can also lead to increased bleeding, infections and hospital re-admissions," says Javad Parvizi, MD, director of Research at the Rothman Institute and lead author on the study.
The study compared the outcomes of 26,415 patients who underwent joint replacement surgery at the Rothman Institute between 2000 and 2011; 1,824 of whom received aspirin and 24,567 of whom received warfarin prophylactically prior to surgery. Both groups were monitored for up to 90 days post-operatively.
Their results showed the overall rate of pulmonary embolism to be significantly lower in the patients who received aspirin (0.2 percent or four in 1,824) versus those who received warfarin (1.0 percent or 92 in 9028). In addition, hematoma, a leakage of blood external to the blood vessel or a leakage of fluid known as a seroma, wound problems, acute infection and 90-day mortality rates were also lower in the aspirin group.
"Our study shows that aspirin is a viable alternative to warfarin in healthy patients, with better results in preventing clots, and a lower rate of bleeding and wound complications," says Parvizi. "It will allow all us to move away from expensive, inconvenient, and dangerous drugs in the prevention of thromboembolism after joint replacement." Rothman Institute at Jefferson surgeons have begun to replace warfarin with aspirin for pre-surgical prophylactic clot prevention.