DoACs vs LMWH for blood flow after knee replacement
Official title: Direct Oral Anticoagulants (DOACs) Once Daily (OD) Versus Direct Oral Anticoagulants (DOACs) Twice Daily (TD) Versus Low-Molecular-Weight Heparin (LMWH) for Thromboprophylaxis After Primary Total Knee Arthroplasty: A Duplex Ultrasound Assessment
Run by Military Hospital of Tunis · NCT07869615 · Data updated 2026-11-12
This study tests whether rivaroxaban, apixaban, or LMWH work differently to support blood flow in the legs after total knee replacement in adults.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years to 80 Years |
| Sex | All |
| Enrollment | 138 (estimated) |
| Sponsor | Military Hospital of Tunis Academic / other |
| Locations | 1 site (Tunis, Tunis Governorate) |
| Status | Recruiting |
| Started | September 15, 2026 |
| Main results expected | April 15, 2027 |
| Study ends | April 15, 2027 |
| Registry record updated | October 16, 2026 |
| Trial ID | NCT07869615 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (18+) undergoing elective primary unilateral total knee arthroplasty who can provide informed consent and have no contraindications to the study drugs.
✕Probably not a fit
Patients with contraindications to anticoagulation, inability to follow up, or conditions excluded by the criteria may not benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This trial compares three pharmacologic thromboprophylaxis regimens in adults undergoing primary unilateral total knee arthroplasty: rivaroxaban 10 mg daily, apixaban 2.5 mg twice daily, and LMWH once daily. Researchers use duplex Doppler ultrasound to measure venous blood flow parameters up to 28 days post-surgery and will monitor rehabilitation, bleeding, and thromboembolism events. Participants are randomized to one of the three treatments starting 24 hours after surgery, with LMWH given 6 hours post-op as initial prophylaxis, and treatment planned for 14 days. The primary endpoint is peak systolic velocity in major lower-limb veins, with secondary Doppler and clinical assessments. The study is conducted at the Military Hospital of Tunis, led by the Principal Military Hospital of Instruction of Tunis.
Why it matters
Potential benefit: If successful, the study could clarify which regimen best preserves lower-limb venous flow after knee replacement, potentially reducing thromboembolism risk.
How similar studies have gone: Prior research supports pharmacologic prophylaxis after knee arthroplasty, but this specific head-to-head Doppler flow comparison is relatively novel.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults aged 18 years or older undergoing elective primary unilateral total knee arthroplasty. * Able to provide informed consent. Exclusion Criteria: * Allergy or contraindication to the study medications. * Requirement for long-term therapeutic anticoagulation. * Requirement for antiplatelet therapy. * Pregnancy or lactation. * Active cancer or cancer treatment. * Documented previous venous thromboembolism in the target limb. * Hypercoagulable state. * BMI \>40 kg/m². * Severe inflammatory disease. * Age \>80 years. * Inability to comply with follow-up. * Incomplete data.
Where it's running
-
Principal Military Hospital of Instruction of Tunis
Tunis, Tunis Governorate, Tunisia Recruiting
Study contacts
- Study coordinator: Haythem Elaskri
- Email: haythem.elaskri@fmt.utm.tn
- Phone: 54015050
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
-
Mind mapping-based education to help after knee replacement
A group of adults having total knee replacement will receive mind-mapping education in addition to standard care to see if it helps with pain, fear of movement, and readiness to leave the hospital.
-
Prognostic value of the 2026 AHA/ACC PE classification in ED patients with acute PE
This study tests whether the 2026 AHA/ACC five-category PE classification helps predict 30-day major adverse pulmonary embolism events in adults with acute PE presenting to the ED.
-
Branched chain amino acids after knee replacement to help muscle
This trial tests whether giving Livact after knee replacement helps preserve muscle and function in adults with sarcopenia.
-
Cryotherapy to Cut Opioid Use After Knee Replacement
This trial tests whether compressive cryotherapy with a Game Ready device can lower opioid use and improve recovery after total knee replacement in adults 60–80.
-
Early cognitive changes after same-day hip or knee replacement
This study tests whether older adults (65 or older, 70 per description) who have same-day discharge after hip or knee replacement show changes in cognitive test performance from before surgery to the first day after surgery.
-
Preoperative Genicular Nerve Block for Knee Replacement
This study tests whether giving a genicular nerve block before knee replacement can reduce pain after surgery and lower opioid use.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.