New oral anticoagulants for thromboprophylaxis after total hip or knee arthroplasty

Orthopedics. 2009 Dec;32(12 Suppl):79-84. doi: 10.3928/01477447-20091103-53.

Abstract

Patients undergoing total hip or knee arthroplasty are at increased risk of venous thromboembolism (VTE). The long-term sequelae of VTE, such as post-thrombotic syndrome or pulmonary hypertension, can be debilitating with severe morbidity. Conventional anticoagulants have several short-comings: for example, warfarin requires regular coagulation monitoring and low-molecular-weight heparins are inconvenient to use because they require subcutaneous administration. The development of new anticoagulants has focused on 2 classes of compounds: direct thrombin inhibitors and direct factor Xa inhibitors. These new oral agents have shown efficacy in large randomized clinical trials and offer new, more convenient options for anticoagulation.

MeSH terms

  • Administration, Oral
  • Anticoagulants / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / methods
  • Drug Design*
  • Factor Xa Inhibitors
  • Humans
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Primary Prevention
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / prevention & control
  • Randomized Controlled Trials as Topic
  • Thrombin / antagonists & inhibitors
  • Venous Thrombosis / etiology
  • Venous Thrombosis / prevention & control*

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Thrombin