Time for an Update? A Look at Current Guidelines for Venous Thromboembolism Prophylaxis After Hip and Knee Arthroplasty and Hip Fracture

Venous thromboembolism is a well-established complication of total hip and knee arthroplasty and hip fracture surgery. Clinical practice guidelines have been proposed to help clinicians provide prophylaxis against this risk. However, most guidelines reference data that are becoming outdated because...

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Bibliographic Details
Published in:Arthroplasty today 2021-08, Vol.10, p.105-107
Main Authors: Muscatelli, Stefano R., Charters, Michael A., Hallstrom, Brian R.
Format: Article
Language:English
Subjects:
Anticoagulation
Guidelines
Hip fracture
Total hip arthroplasty
Total knee arthroplasty
Venous thromboembolism
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Summary:Venous thromboembolism is a well-established complication of total hip and knee arthroplasty and hip fracture surgery. Clinical practice guidelines have been proposed to help clinicians provide prophylaxis against this risk. However, most guidelines reference data that are becoming outdated because of new advances in perioperative protocols. Recent data would suggest that aspirin may be appropriate for most patients after total hip and knee replacement and a more potent chemoprophylaxis for higher risk patients. Low-molecular-weight heparin remains the recommended choice after hip fracture surgery, although there is a paucity of recent literature in this patient population. There are randomized trials currently underway in the arthroplasty population that may guide clinicians in the appropriate choice of chemoprophylaxis. These studies should inform updates to the current clinical practice guidelines.
ISSN:2352-3441
2352-3441
DOI:10.1016/j.artd.2021.06.015