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The use of factor Xa inhibitors following opening-wedge high tibial osteotomy for venous thromboembolism prophylaxis

Abstract

Purpose

This study aimed to investigate the incidence of venous thromboembolism (VTE) after medial opening-wedge high tibial osteotomy (OWHTO) and evaluate the efficacy and safety of edoxaban for the prevention of VTE in patients undergoing OWHTO.

Methods

A total of 139 patients with osteoarthritis or osteonecrosis undergoing OWHTO were enrolled in this prospective, randomized study. Four patients were excluded because of preoperatively diagnosed VTE, and 135 patients were divided into two groups—an edoxaban group and a non-edoxaban group—and underwent computed tomography venography on day 7 to check for postoperative VTE. Blood samples were taken on the day before OWHTO and on postoperative days 1, 3, 7, and 14.

Results

Treatment with edoxaban reduced the incidence of VTE after OWHTO; however, there was no statistically significant difference between the two groups. No major bleeding was noted in the edoxaban group. There were significant differences in the D-dimer level, prothrombin time, fibrinogen level, and thrombin antithrombin complex levels between the groups.

Conclusions

Edoxaban is an oral, once-daily, selective, direct factor Xa inhibitor that is safe and easy to handle. It may offer a new option for preventing VTE after OWHTO.

Level of evidence

I.

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Correspondence to Hideo Kobayashi.

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The authors have no conflict of interest to report. No funding was received to support the research or data analysis in this article. In addition, we have not received funding from any agency that requires us to deposit a copy of the article in a public access database.

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Kobayashi, H., Akamatsu, Y., Kumagai, K. et al. The use of factor Xa inhibitors following opening-wedge high tibial osteotomy for venous thromboembolism prophylaxis. Knee Surg Sports Traumatol Arthrosc 25, 2929–2935 (2017). https://doi.org/10.1007/s00167-016-4065-6

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Keywords

  • Opening-wedge high tibial osteotomy (OWHTO)
  • Venous thromboembolism (VTE)
  • Deep vein thrombosis (DVT)
  • Pulmonary embolism (PE)
  • Edoxaban