Aspirin and blood clots | Knee Replacement Risks

It takes the edge off headaches, dulls toothache, makes period pains more manageable, helps you tackle colds and flu, and even be used to help prevent heart attacks and strokes. And according to a recent study from the University of Michigan, there’s a new use for the humble aspirin: as a cheap and effective replacement for expensive anticoagulant drugs to prevent the knee replacement surgery complication of blood clots.

Anticoagulant medication is a crucial component of the post-knee surgery recovery period because although the chances of a blood clot after knee surgery isn’t at all commonplace, it’s still something you really don’t want, as it could be fatal. There are plenty of anticoagulant options available to the medical community, but they all ‘up there’ in cost and make an expensive procedure even more expensive. So, finding a cheaper alternative with the same benefit would be a huge fillip to the global health community.

A cheap and accessible solution?

The study, which was published in JAMA Surgery last month, combed through the medical records of 41,537 patients in the US who had undergone knee surgery between 2013 and 2015, with a firm eye upon the medication they received after the op and the incidences of thrombosis – the medical term for a blood clot.

Among those who received no medicine post-surgery, the rate of thrombosis was 4.79 per cent. For those who were given prescription anticoagulants, the rate was 1.42 per cent. For those who were prescribed both an anticoagulant and aspirin, 1.31 per cent developed clots. But for those who used nothing but aspirin, the rate was 1.16 per cent. The research team deemed the statistical differences as ‘insignificant’.

The other key finding involved bleeding complications – a regular although comparatively rare consequence of using blood-thinning drugs – but the researchers found no difference between aspirin and the prescription drugs in the risk for that side effect either.

Is this the beginning of a switch away from expensive medication and a move towards something we can pick up from the supermarket for pennies? Not necessarily so, according to Dr Brian R. Hallstrom, an associate professor of surgery at the University of Michigan and the senior author of the study, who went to great pains to point out that the patients in the study had their medications selected by their doctors, and that the study itself was not a randomised trial. For example, if he were treating a patient who had experienced a blood clot in the past, he would still use anticoagulants. But he added; “Most people can get aspirin alone without much concern.”

In the meantime, it makes sense to touch upon what you, as a post-op patient, can do to avoid blood clotting. Two of the biggest risk factors for blood clotting is a previous history of blood clots, and if the patient is currently undergoing treatment for cancer. While you can’t do anything about either of those issues, you can take steps to avoid cutting by avoiding the other danger areas: excess weight, sedentary lifestyle, and a smoking habit.

Also, if there’s a family history of blood clotting or you’re taking hormonal medication (such as birth control), your knee replacement surgery specialist will establish this when taking your medical history prior to surgery.

Blood clots are a risk after any orthopaedic surgery, but preventative measures adopted by Mr Jonathan Webb and his team have greatly reduced this risk.