Bleeding Risk with Rivaroxaban, Enoxaparin, and Aspirin Following Total Joint Arthroplasty or Revision

Paula J. Watts DO, HCA Healthcare
Mickey Kopstein DO, HCA Healthcare
Weston Harkness DO, HCA Healthcare
Brendon Cornett, HCA Healthcare
Mitchel Brown DO, HCA Healthcare
Oliwier Dziadkowiec
Elizabeth Hicks MD, HCA Healthcare
Shakib Hassan MD, HCA Healthcare
Dmitriy Scherbak DO, HCA Healthcare


Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a potentially fatal byt preventable complication of orthopedic surgery. Following surgery, patients are routinely started on prophylactic oral or pareteral anticoagulation. Standard medicaions used in this setting include enoxaparin, low-dose ungractionated heparin, vitamin K antagonists, fondaparinux, apixaban, dabigatran, rivaroxaban, and aspirin. A major risk when using these medications is bleeding and must be considered when choosing among them.