Prophylaxis for Venous Thromboembolic Events in Elective Total Hip and Total Knee Arthroplasty.

Theofilos Karasavvidis, Vasileios Bouris, William Xiang, Georgios Tzavellas, Nektarios Charisis, Leonidas Palaiodimos, Vassiliki Kigka, Christos V Bourantas, Ioannis Gkiatas

Journal: Current pharmaceutical design 2022;28(10):771-777

PMID: 35440299

Abstract

Venous thromboembolism (VTE) is a serious complication after major orthopaedic operations, such as a total hip (THA) and knee (TKA) arthroplasty. Therefore, perioperative VTE prophylaxis is recommended; a multitude of modern options are available, including both pharmacologic (aspirin, unfractionated and lowmolecular- weight heparin, vitamin K antagonists, and novel oral anticoagulants) and/or mechanical interventions (early mobilization, graduated compression stockings, intermittent pneumatic compression devices, and venous foot pumps). However, because of the abundance of these possibilities, it is crucial to understand the benefits and drawbacks of each VTE prophylaxis option to ensure that the optimal treatment plan is developed for each patient. The American College of Chest Physicians (AACP) and the American Academy of Orthopaedic Surgeons (AAOS) have both published individual guidelines on VTE prophylaxis regimens, alongside numerous studies evaluating the efficacy and outcomes of the different prophylaxis modalities. The purpose of this review is to provide a summary of the evidence on VTE prophylaxis after elective total hip and knee arthroplasty based on current guidelines and highlight the major concerns and potential complications.

Copyright© Bentham Science Publishers; For any queries, please email at [email protected].

Address: School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.; Department of Vascular Surgery, General Hospital of Athens G. Genimatas, Athens, Greece.; Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece.; Department of Vascular Surgery, Ball Memorial Hospital, Muncie, IN, USA.; Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, USA.; Department of Medicine, Albert Einstein College of Medicine, The Bronx, NY, USA.; School of Medicine, University of Ioannina, Ioannina, Greece.; Institute of Cardiovascular Sciences, University College London, London, UK.; Department of Cardiology, Barts Health NHS Trust, London, UK.
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