Document Type
Article
Publication Title
Journal of Orthopaedic Reports
Abstract
Background: Venous thromboembolism prophylaxis (VTE) is a major consideration in orthopaedic trauma surgery. In recent years, there has been an increasing debate about whether patients should be given enoxaparin or aspirin as VTE prophylaxis medication. The objective of this systematic review is to compare enoxaparin versus aspirin for VTE prophylaxis in orthopaedic trauma patients.
Methods: A search was conducted across six databases. The search used a combination of keywords and Medical Subject Headings (MeSH) terms. Titles and abstracts were screened for eligibility based on the inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from the articles that met the inclusion criteria. Results: Ten studies met the inclusion criteria in this systematic review. Overall, studies showed that aspirin was equivalent to enoxaparin for venous thromboembolism (VTE) prevention and complications in orthopaedic trauma surgery. Aspirin was found to be comparable to enoxaparin for VTE prevention and complications in low-risk, medium-risk, and high-risk patients. Patients had similar compliance between both medications; however, they had higher satisfaction and felt less burden with aspirin. Patients had a higher chance of incurring out-of-pocket costs with aspirin; however, they had improved odds that these costs would be less than $25.
Conclusion: While this study is limited by study heterogeneity and the absence of a meta-analysis, the current literature suggests that aspirin shows no significant differences in VTE prevention or complication rates compared to enoxaparin for venous thromboembolic prophylaxis in orthopaedic trauma surgery. Future high-level comparative studies are needed to compare these two medications further.
Level of evidence: Level 4; Therapeutic
DOI
10.1016/j.jorep.2026.100964
Publication Date
3-18-2026
Keywords
Venous thromboembolism/prevention & control, Aspirin/therapeutic use, Enoxaparin/therapeutic use, Orthopaedic procedures, Wounds and injuries
ISSN
2773-157X
Recommended Citation
Puga TB, Box M, Marchese C, Ferguson C, Poffenbarger M, Riehl J. Aspirin Versus Enoxaparin for Venous Thromboembolism (VTE) Prophylaxis in Orthopaedic Trauma Surgery: A Systematic Review. Journal of Orthopaedic Reports. 2026; . doi: 10.1016/j.jorep.2026.100964.
