One size Doesn't fit all: new trial tests tailored blood thinners for joint replacement patients
NCT ID NCT06581965
First seen Jun 25, 2026 · Last updated Sep 09, 2026 · Updated 3 times
Summary
After hip or knee replacement, all patients currently get the same dose of blood thinners to prevent clots, but some still get clots while others bleed. This trial will test whether giving a shorter course to low-risk patients and a stronger, longer course to high-risk patients can reduce both clots and bleeding. Over 10,000 adults scheduled for joint replacement will be randomly assigned to either standard or personalized treatment and followed for three months.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- blood thinners (LMWH or DOACs)
- What this could lead to
- If successful, this could show that customizing blood thinner treatment after joint replacement lowers the risk of both dangerous clots and bleeding complications.
- What could go wrong
- This is a large Phase 4 trial, but individualizing treatment may still fail to improve outcomes or could increase risks in some patients. Results may not apply to all hospitals or patient groups.
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
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Phase 4
Runs after approval, following long-term safety and how well the treatment works in everyday use.
- Participants
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About 10,078 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Nov 2024
- Expected to finish
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Feb 2031
An estimate. End dates often move.
- Lead sponsor
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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
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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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 Hide 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: * Scheduled to undergo an elective total hip arthroplasty or total knee arthroplasty * Aged 18 years or older Exclusion Criteria: * Primary arthroplasty for fractures * Revision surgery * Hemiarthroplasty * Pregnancy * Current use of therapeutic anticoagulant therapy of any type (e.g., LMWH, DOAC, vitamin K antagonist) * A contraindication for either study drug * Insufficient knowledge of the Dutch language * Insufficient mental or physical ability to fulfil trial requirements * Active malignancy (i.e. cancer diagnosis within six months before surgery (excluding basal-cell or squamous-cell carcinoma of the skin), recently recurrent or progressive cancer or any cancer that required anti-cancer treatment within six months before surgery) * Patients using thrombocyte aggregation inhibitors that cannot be temporarily discontinued at the discretion of their treating physician
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
13 sites. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Alrijne
RECRUITINGLeiderdorp, South Holland, 2353 GA, Netherlands
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Anna Ziekenhuis
RECRUITINGGeldrop, North Brabant, 5564EH, Netherlands
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Bergman Clinics
RECRUITINGNaarden, North Holland, 1411DE, Netherlands
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Elisabeth-TweeSteden Ziekenhuis
RECRUITINGTilburg, North Brabant, 5022GC, Netherlands
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Gelre Ziekenhuizen
RECRUITINGApeldoorn, Gelderland, 7334 DZ, Netherlands
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Groene Hart Ziekenhuis
RECRUITINGGouda, Netherlands
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IJsselland Ziekenhuis
NOT_YET_RECRUITINGCapelle aan den IJssel, Netherlands
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Isala ziekenhuis
RECRUITINGZwolle, Overijssel, 8025AB, Netherlands
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OLVG
RECRUITINGAmsterdam, North Holland, 1091AC, Netherlands
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Reinier Haga Orthopedisch Centrum
RECRUITINGZoetermeer, South Holland, 2725NA, Netherlands
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St. Antonius Ziekenhuis
RECRUITINGUtrecht, Utrecht, Netherlands
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ZorgSaam
RECRUITINGTerneuzen, Zeeland, Netherlands
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Zuyderland
RECRUITINGGeleen, Limburg, 6162 BG, Netherlands
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Can a phone app stop deadly clots from coming back?
- Can electronic alerts and patient teaching stop deadly clots after cancer surgery?
- Can a new Five-Category system predict which pulmonary embolism patients will crash?
- A quick ultrasound in the ER: could it replace blood tests for blood clots?
- Can we predict who dies from blood clots? a 100,000-Patient study searches for clues
- A new exercise plan aims to get pulmonary embolism survivors back on their feet