Rivaroxaban vs. Enoxaparin for Preventing Venous Thromboembolism and Wound Complications after Knee Surgery: A Meta-Analysis.

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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP Pub Date : 2025-10-01 DOI:10.29271/jcpsp.2025.10.1318

Shasha He, Xiangbao Yin, Yingqi Xu, Zhiwei Zhong

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Abstract

A systematic review was conducted to compare rivaroxaban with enoxaparin in the prevention of venous thromboembolism (VTE) and wound complications after total knee arthroplasty. Comprehensive searches of electronic databases were conducted, encompassing Medline/PubMed, Embase, and the International Clinical Trials Registry Platform (ICTRP), covering all the available literature up to January 2022. Adhering to the Cochrane methodology for systematic reviews, two independent researchers meticulously screened the retrieved studies, extracted pertinent data, and assessed the quality of the evidence. The review included six studies with 6,627 patients, sourced from Medline/PubMed, Embase, and clinical trial registries. Meta-analysis showed that rivaroxaban significantly reduced symptomatic VTE and deep vein thrombosis (DVT), with relative risks (RR) of 0.55 (p = 0.009) and 0.44 (p = 0.007), respectively. However, there was no significant difference in symptomatic pulmonary embolism (PE), wound complications, major bleeding, or mortality (all p >0.05). Rivaroxaban demonstrated superior efficacy for VTE and DVT prevention without increasing major risks. Key Words: Enoxaparin, Meta-analysis, Rivaroxaban, Wound complications.

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利伐沙班与依诺肝素预防膝关节术后静脉血栓栓塞和伤口并发症的meta分析

对利伐沙班和依诺肝素在预防全膝关节置换术后静脉血栓栓塞（VTE）和伤口并发症方面的效果进行了系统评价。全面检索电子数据库，包括Medline/PubMed、Embase和国际临床试验注册平台（ICTRP），涵盖截至2022年1月的所有可用文献。遵循Cochrane系统评价方法，两位独立研究人员精心筛选检索到的研究，提取相关数据，并评估证据质量。该综述纳入了来自Medline/PubMed、Embase和临床试验注册的6项研究，共6627例患者。荟萃分析显示，利伐沙班显著降低症状性静脉血栓形成（VTE）和深静脉血栓形成（DVT），相对危险度（RR）分别为0.55 （p = 0.009）和0.44 （p = 0.007）。然而，在症状性肺栓塞（PE）、伤口并发症、大出血或死亡率方面，两组差异无统计学意义（p < 0.05）。利伐沙班在预防静脉血栓栓塞（VTE）和深静脉血栓栓塞（DVT）方面表现出卓越的疗效，且未增加主要风险。关键词：依诺肝素，meta分析，利伐沙班，伤口并发症。

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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

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