Aspirin is as effective as low molecular weight heparins in preventing symptomatic venous thromboembolism following arthroscopic anterior cruciate ligament reconstruction

Objective: Little evidence exists on the optimal agent for thromboprophylaxis following arthroscopic anterior cruciate ligament reconstruction (ACLR). This study was conducted to compare the effectiveness of aspirin and low molecular weight heparins (LMWHs) to prevent symptomatic venous thromboembolism (VTE) following arthroscopic ACLR and their safety of use. Methods: In this retrospective study, we investigated patients who underwent ACLR surgery between March 2016 and March 2021 based on inclusion and exclusion criteria. The rate of venous thromboembolism events and wound complications were statistically compared between the patients that received an LMWH and those who took aspirin for thromboprophylaxis. We also used logistic regression modeling to assess the effect of the prophylactic agent on the likelihood of developing VTE. Result: 761 patients (761 knees) were included. 458 and 303 patients had received aspirin and LMWH, respectively. There was no significant difference in the demographic factors of the two groups. Five patients in the aspirin group (1.09%) and five patients in the LMWHs group (1.65%) developed a symptomatic VTE event (P value = 0.530). The two groups were not significantly different in terms of other complications, such as hemarthrosis or surgical site infection (P > 0.05). Conclusion: Aspirin is as effective as LMWH in preventing VTE events after ACL reconstruction. Prospective studies including a no-prophylaxis group are warranted to assess this issue further. Level of Evidence III