11 randomized controlled trials with 31,319 patients undergoing total knee or hip replacement and receiving either low molecular weight heparin (LMWH) or non-vitamin K antagonist oral anticoagulants (NOACs) for venous thromboembolism prophylaxis were included in this meta-analysis. The analysis was conducted in order to assess the incidence of postoperative arterial thrombosis (AT) following administration of NOAC and LMWH. Findings indicated that in both knee and hip arthroplasty, LMWH and NOACs result in a similar risk of arterial thrombosis events, including acute myocardial infarction and ischemic stoke.