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

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.