| Summary: | Patients undergoing orthopedic surgery, particularly total hip or knee replacement, also referred as total hip arthroplasty (THA) or total knee arthroplasty (TKA), are at high risk of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic VTE following THA or TKA in patients receiving pharmacologic prophylaxis has been reported to be at 0.5 to 1% during in-hospital stay, and potentially increased up to 2% during 90 days after surgery. Current available chemoprophylactic agents include low molecular weight heparin (LMWH; enoxaparin, dalteparin), vitamin K antagonists (warfarin), direct Factor Xa inhibitors (rivaroxaban, apixaban), direct thrombin inhibitor (dabigatran) and aspirin (also known as acetylsalicylic acid, ASA). Unlike the other anticoagulants, ASA does not affect any step in the coagulation cascade, rather it irreversibly inhibits cyclooxygenase-1, an enzyme involved in platelet aggregation. Interest in ASA as a means of VTE prophylaxis has recently grown, and recent literature suggests that ASA could be a viable option for VTE prophylaxis following THA or TKA, due to its potentially favorable efficacy and safety profile. The aim of this report is to review the evidence regarding the clinical effectiveness and evidence-based guidelines regarding the use of ASA for VTE prophylaxis in patients undergoing THA or TKA.
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