Is aspirin alone sufficient for for venous thromboembolism (VTE) prophylaxis following total knee arthroplasty ? A question of great interest has been addressed in a recent study of 41 537 patients who underwent the procedures with monitoring for events extending for 90 days after surgery. The primary composite outcome was the first occurrence of VTE or death. The mean age of subjects as was 65.8 years. A VTE event occurred in 573 of 41 537 patients (1.38%); 32 of 668 (4.79%) who received no pharmacologic prophylaxis, 149 of 12 831 (1.16%) treated with aspirin alone, 321 of 22 620 (1.42%) with anticoagulation alone, and 71 of 5418 (1.31%) prescribed both aspirin and anticoagulation. Bleeding occurred in 457 of 41 537 patients (1.10%), – 10 of 668 (1.50%) without prophylaxis, 116 of 12 831 (0.90%) in the aspirin group, 258 of 22 620 (1.14%) with anticoagulation, and 73 of 5418 (1.35%) of those receiving both. Aspirin was not statistically or clinically inferior to other approaches assessed in this study, which was recently reported in JAMA Surgery.