Commentary

more than LMWH in total knee or hip replacement Neumann I, Rada G, Claro JC, et al. Oral direct factor Xa inhibitors versus low-molecular-weight heparin to prevent venous thromboembolism in patients undergoing total hip or knee replacement: a systematic review and meta-analysis. Ann Intern Med. 2012;156:710-9. Clinical impact rating: H Subgroup analysis showed that higher doses of factor Xa inhibitors (odds ratio 2.5, 95 % CI 1.4 to 4.5), but not lower doses, increased risk for major bleeding (P = 0.02 for interaction). Conclusion In patients having total knee or hip replacement, oral direct factor Xa inhibitors reduced symptomatic deep venous thrombosis com-pared with low-molecular-weight heparin but did not differ for mortality, pulmonary embolism, or bleeding