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Which blood thinner works best after joint surgery? huge study reveals answers

NCT ID NCT02810704

Prevention Sponsor: Dartmouth-Hitchcock Medical Center Source: ClinicalTrials.gov ↗

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed This study
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study compared three common blood thinners—aspirin, warfarin, and rivaroxaban—to prevent dangerous blood clots after hip or knee replacement surgery. Nearly 19,000 adults took part. The goal was to find which option best balances preventing clots with avoiding bleeding side effects.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 4

Runs after approval, following long-term safety and how well the treatment works in everyday use.

Participants

18,883 people

The number who actually took part.

Started

Dec 2016

Finished

Sep 2025

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

21 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. 21 years of age or older; 2. Undergoing elective primary, revision or second stage re-implantation total hip/knee replacement or uni-compartmental knee replacement or hip resurfacing arthroplasty; 3. Has necessary mental capacity to participate and is able to comply with study protocol requirements; 4. Eligible for randomization to at least two of the three study regimens; 5. Is not pregnant on the day of surgery; 6. Has signed the consent form; and 7. Is willing to be randomized and participate in the study. Exclusion Criteria: 1. Undergoing bilateral hip or knee replacement; 2. Has been previously enrolled; 3. Is pregnant or breastfeeding; 4. Is on chronic anticoagulation other than antiplatelet medications; 5. Concurrently enrolled in another active interventional clinical trial testing a drug or intervention known or believed to interact with aspirin, warfarin, or rivaroxaban; 6. Has documented gastrointestinal, cerebral, or other hemorrhage within 3 months; 7. Has a known diagnosis of defective hemostasis and past history of clinical bleeding requiring transfusion and treatment; 8. Has had an operative procedure involving the eye, ear, or central nervous system within one month; 9. Has uncontrolled hypertension with systolic BP \> 220mmHg or diastolic BP \> 120mmHg; 10. Body weight of less than 41 kilograms at baseline visit; 11. Member of a vulnerable patient population.

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Conditions

The condition(s) this trial relates to.

thrombophilia due to thrombin defect venous thromboembolism Venous Thrombosis pulmonary embolism prevention target

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Pulmonary embolism Venous thrombosis

Contacts and locations

Locations

  • Anderson Orthopaedic Institute (VA)

    Alexandria, Virginia, 22306, United States

  • Arthritis Surgery Research Foundation

    South Miami, Florida, 33143, United States

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215, United States

  • Boston University Medical Center

    Boston, Massachusetts, 02118, United States

  • Brigham & Women's Hospital

    Boston, Massachusetts, 02115, United States

  • Cleveland Clinic

    Cleveland, Ohio, 44195, United States

  • Dartmouth-Hitchcock Medical Center

    Lebanon, New Hampshire, 03756, United States

  • Duke University Medical Center

    Durham, North Carolina, 27710, United States

  • Indiana University

    Indianapolis, Indiana, 46037, United States

  • Johns Hopkins University

    Baltimore, Maryland, 21218, United States

  • Lahey Clinic

    Burlington, Massachusetts, 01805, United States

  • Lifespan Health

    East Providence, Rhode Island, 02914, United States

  • London Health Sciences Centre

    London, Ontario, N6A 4V2, Canada

  • Mayo Clinic

    Scottsdale, Arizona, 85259, United States

  • Mayo Clinic

    Rochester, Minnesota, 55905, United States

  • Medical University of South Carolina

    Charleston, South Carolina, 29425, United States

  • New York University

    New York, New York, 10016, United States

  • Northwell Health

    New York, New York, 10075, United States

  • Penn State Hershey Med Center

    Hershey, Pennsylvania, 17033, United States

  • Rush University Medical Center

    Chicago, Illinois, 60612, United States

  • Sinai Hospital

    Baltimore, Maryland, 21215, United States

  • Stanford University Hospital

    Stanford, California, 94305, United States

  • UCLA

    Los Angeles, California, 90404, United States

  • University of Arkansas for Medical Sciences

    Little Rock, Arkansas, 72205, United States

  • University of Nebraska Medical Center

    Omaha, Nebraska, 68198, United States

  • University of Ottawa

    Ottawa, Ontario, K1H 8L6, Canada

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104, United States

  • University of Utah

    Salt Lake City, Utah, 84132, United States

  • University of Virginia

    Charlottesville, Virginia, 22908, United States

  • University of Washington

    Seattle, Washington, 98133, United States

  • Virginia Commonwealth University Medical Center

    Richmond, Virginia, 23284, United States

  • West Virginia University

    Morgantown, West Virginia, 26506, United States

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