Award-Winning Paper from Rothman Orthopaedics and Hackensack University Medical Center Physicians Shows Aspirin Effective for Blood Clots After Knee Replacement

Study Published in The Bone & Joint Journal Establishes Treatment Option with Low Rate of Clot Progression

A new award-winning paper by Rothman Orthopaedic Institute surgeons and researchers affiliated with Hackensack Meridian Hackensack University Medical Center, published in a recent supplement of The Bone & Joint Journal, concludes that aspirin, which is well established as a preventive agent for deep vein thrombosis (DVT), is also effective to treat infrapopliteal DVT (IDVT), blood clots found in the calf muscle, and is associated with a low rate of clot progression or thromboembolic events.

The optimal management of an infrapopliteal deep venous thrombosis, located in veins below the knee, following total knee arthroplasty has not been clearly specified for the clinicians managing postoperative care. This study shows that patients undergoing total knee replacement who developed blood clots below the knee can be effectively treated with aspirin.

While the optimal management of these types of clots following knee replacement surgery needs further prospective study, treatment with aspirin could be a new standard of care in orthopedics. The paper states that the risk of IDVT propagation and symptom progression must be balanced against potential hemorrhagic complications associated with administration of anticoagulation therapy.

Of the total group of 532 patients who had IDVT (out of 5,078 who underwent total knee replacement), 91 percent were treated with aspirin twice daily for three months. The remaining patients who experienced IDVT were treated with anticoagulants other than aspirin. Follow-up ultrasound was performed on 94 percent of the patients with IDVTs treated with aspirin, and 2 percent showed propagation of the IDVT.

Gregg R. Klein, M.D., is the paper’s corresponding author from Rothman Orthopaedics and Physician Associate, Vice Chairman, Department of Orthopedic Surgery, Hackensack University Medical Center, and Associate Professor, Department of Orthopedic Surgery, Hackensack Meridian School of Medicine. Additional co-authors of Dr. Klein’s research who are affiliated with Hackensack University Medical Center and Rothman Orthopaedics include Harlan Brett Levine, M.D., and Ari Seidenstein, M.D. Bertrand Parcells, M.D., from Jersey Shore University Medical Center and Ocean Medical Center, also contributed to the research

The Knee Society chose to recognize this groundbreaking research with the 2021 John N. Insall Award. The Insall Award was established to honor the pioneering English orthopedic surgeon Dr. John Nevall Insall, who made extraordinary contributions to the field of orthopedics. The award recognizes outstanding papers concerning clinical results and techniques.

Learn More about orthopedic care advancements happening at Hackensack University Medical Center.

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