Discussion
RA, VTE, TKA, bleeding
ADVERSE EFFECTS, BLEEDING, COMPLICATION
The most important finding of this study was that ASA, RA, and Dalteparin sodium were all effective on preventing VTE after TKA in the context of TXA application. In addition, ASA dramatically reduced post-treatment Hb loss, drainage volume, TBL, blood transfusion rate, and bleeding complication rate compared with RA and Dalteparin sodium. It is reported that if VTE prevention is not performed in major orthopedic surgery, the natural incidence rate is as high as 40–60%, by contrast, the incidence rate of symptomatic VTE in 3 months is only 1.3–10% through routine VTE prevention [In this study, ASA evidently reduced post-treatment Hb loss, drainage volume, TBL, blood transfusion rate, and bleeding complication rate compared with RA and Dalteparin sodium. Bala et al. [Certain limitations should be noted in this study. First, this study had a small sample size, and the findings might be somewhat biased. Second, patients with severe comorbidities were excluded, while the relatively healthy patients were included in this study. The healthy study population might raise a concern of representing the majority of TKA patients regarding the application of antithrombotic agents. However, a randomized controlled trial was carried out to avoid selection bias, and the exclusion criteria seemed reasonable considering the potential adverse effects of antithrombotic agents.