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Clinical Benefits of Rivaroxaban for Thromboprophylaxis after Knee and Hip Replacement Surgery. A Review of the RECORD Trial Program

Davide Imberti, MD, and Chiara Dall’Asta, MD

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in patients undergoing major orthopaedic surgery. Routine thromboprophylaxis has been the standard of care for the last 20 years. The options currently available
to orthopaedic surgeons for the prevention of VTE in patients undergoing major surgery include low-molecular-weight heparins, vitamin K antagonists, and more recently the synthetic pentasaccharide fondaparinux. Although effective, these drugs have several limitations and oral antithrombotics offering predictable, effective, and safe anticoagulation are needed. Rivaroxaban is the first of the new class of oral, once-daily, direct Factor Xa inhibitors to be extensively studied in large randomized clinical trials of patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA). The recently published results of the RECORD trials clearly demonstrate that rivaroxaban 10 mg/day is significantly more effective at reducing VTE complications in THA and TKA than the standard European and US enoxaparin regimens, with a comparable risk of major bleeding.Adv Orthop 2008;11(1):2–8.

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