Abstract
The review of literature with a high degree of scientific evidence on pharmacological thromboprophylaxis in orthopedic surgery in non-hemophilia patients, the analysis of literature on thromboprophylaxis in orthopaedic surgery in people with hemophilia and our own experience of 40 years performing orthopedic surgery on hemophilia patients, leads us to the conclusion that we cannot currently recommend pharmacological thromboprophylaxis extensively in hemophilia patients undergoing orthopedic surgery, in which we have always used general anesthesia. In fact, we have never performed pharmacological thromboprophylaxis (although we have always practiced rapid postoperative mobilization of patients after orthopedic surgery). This sharply contrasts with what the literature recommends for non-hemophilia patients: mixed pharmacological and mechanical thromboprophylaxis is highly recommended. However, our opinion is that if we detect several risk factors for thromboembolism in a hemophiliac patient who is to undergo orthopedic surgery, we should carry out the same type of pharmacological thromboprophylaxis recommended for non-hemophilia patients.
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