Results from the CRISTAL randomized trial published in JAMA demonstrated that Enoxaparin acted as a better option than aspirin for preventing symptomatic venous thromboembolism (VTE) after total hip or total knee arthroplasty used without initial anticoagulation.

The study enrolled 9711 eligible patients and divided them into two groups. Following total hip arthroplasty (THA), the groups received either aspirin (100 mg/d) or Enoxaparin (40 mg/d) for 35 days and the same regimen for 14 days after total knee arthroplasty (TKA). The primary outcome was symptomatic VTE, which included pulmonary embolism and deep vein thrombosis within 90 days (DVT).

It was observed that within 90 days of surgery, symptomatic VTE was seen in 256 patients, including pulmonary embolism (79 instances), above-knee DVT (18 cases), and below-knee DVT (174 cases). The rate of symptomatic VTE was 1.82% in Enoxaparin group compared to 3.45% in the aspirin group (estimated difference, 1.97%; 95% CI, 0.54%-3.41%).

Thus, the study concluded that Enoxaparin caused a considerably lower rate of symptomatic VTE within 90 days than aspirin among patients having hip or knee arthroplasty for osteoarthritis.  (MedPage Today; August 23, 2022)