الفهرس 
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Abstract
Osteoarthritis is one of the most common diseases that affect geriatric population. Severe cases of knee osteoarthritis eventually need to have Total Knee Arthroplasty (TKA), after conservative treatment has failed. During the last few decades, the number of arthroplasties increases each year. (1)
On the other hand, Patients undergoing an arthroplasty are at risk of venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE). In the absence of prophylaxis, VTE may occur in more than 35% of patients undergoing an arthroplasty. Because of the relatively high incidence of VTE, prophylaxis has been recommended after arthroplasty. (2,3)
The aim of this study was to assess the effectiveness and safety of Aspirin as a prophylaxis of venous thromboembolism compared with the oral anticoagulant after knee arthroplasty.
This was a prospective study that targets a convenient sample which included (40) patients. The study included all patients admitted to Menoufia University Hospital and Om Elmasrien hospital to have primary total knee arthroplasty from April 2019 to December 2019. Patients were alternatively divided into two groups:
group (A) received Rivaroxaban 10 mg oral per day for 14 days starting from the first day post-operative (12 hours after surgery).
group (B) received Aspirin 81 mg oral per day for 14 days starting from the first day post-operative (12 hours after surgery).
The present study revealed that no statistically significant differences were found between both groups as regards the post-operative incidence of lower limb edema, major bleeding, wound infection or GIT bleeding. On the other hand, a statistically significant difference (p=0.018) was found between both groups as regards the post-operative incidence of minor bleeding as it did not occur in 100% of the patients in the aspirin group and occurred in the form of ecchymosis in 25% of the patients in the rivaroxaban group. Nearly similar findings were published by Anderson et al. (9) in 2018 who performed a similar study on 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) aiming to compare the effects of aspirin with direct oral anticoagulants for prophylaxis against venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty beyond hospital discharge . They found that no statistically significant differences were found between both groups as regards major or clinically relevant non-major bleeding complications. These findings are also comparable to those published by Huang et al. (121) in 2019 who performed their study on 390 patients aiming to compare the efficacy and safety of aspirin with rivaroxaban following treatment with enoxaparin for prevention of VTE after hip fracture surgery. They found that no statistically significant differences were found between both groups as regards the rates of major bleeding events or clinically relevant non-major bleeding. And most recently , similar findings were also published by Xu et al. (122) in 2020 who performed a meta-analysis which enrolled five studies with a total of 2257 patients in the aspirin group and 2337 patients in the rivaroxaban group aiming to compare the efficacy of aspirin against rivaroxaban for the prevention of VTE following TKA and THA . They found that there were no differences between aspirin and rivaroxaban groups for either major bleeding, any bleeding, or wound complications.