Dr. Tan and coauthors from the Rothman Clinic presented their results at the 25th anniversary of the American Association of hip and knee surgeons in Dallas, Texas November 2015, looking at a multicenter study of 63,526 primary and revision joint replacements. In low risk patients, they found the incidence of lower extremity blood clots using aspirin to be the lowest at 0.17%. In high-risk individuals (those with prior DVT history of clotting or other factors that make them high risk) the incidence of lower extremity blood clots using aspirin was 1.5% versus 3.48% for more potent anticoagulation agents. They concluded that high-risk patients can be adequately prophylaxed with aspirin to try and prevent postoperative blood clots. Further work on this subject needs to be performed before there is overall consensus with this recommendation.
It should be noted that in patients who had no prior blood clots in their lower extremities and do not have some genetic preponderance to lower extremity blood clots, aspirin is evolving to be the most common form of prophylaxis after hip and knee replacement surgery.