[New oral anticoagulants for thromboprophylaxis under routine use of tranexamic acid after hip joint arthroplasty]

To evaluate the efficacy and safety of the novel oral anticoagulants under conservative hemostasis with tranexamic acid in hip arthroplasty.

All patients received 40 mg of enoxaparin 12 hours prior to surgery and on the operating day, and then they received either 10 mg of rivaroxaban (40 patients), 220 mg of dabigatran (42 patients) or 40 mng of enoxaparin (39 patients). Tranexamic acid with doses of 10 - 20 mg/kg was administered to all patients: within 30 minutes prior to surgery and 6 hours after the first infision. The hemorrhagic and thrombotic complications in a hospital outpatient therapy and outcomes in 35 days after surgery were evaluated.

Minor bleeding was observed only in the rivaroxaban group, the complications rate in hospital was 2.5%, among outpatients 3.1%. At hospital discharge the DVT was 12.5% in rivaroxaban group, 7% in dabigatran and 8% in enoxaparin group (p>0.05). Asymptomatic distal DVT was found in 82% of patients by ultrasound screening.

The new oral anticoagulants are effective and safe for venous thromboembolism preventing after hip re placement. Routine use of tranexamic acid was not accompanied by increased risk of DVT