Preventing Venous Thromboembolic Events After Total Hip Arthroplasty: New Developments in Clinical Practice

Abstract

Total hip arthroplasty is a frequently performed orthopedic surgical procedure, and the number of these surgeries is expected to increase significantly over the coming years. Patients undergoing joint arthroplasty are at a particularly high risk for developing venous thromboembolic events (eg, deep vein thrombosis and pulmonary embolism). Prevention of postoperative complications is an important responsibility not only for orthopedic surgeons, but also for other clinicians involved in patients' care. Effective thromboprophylaxis is crucial to reduce the risk of developing venous thromboembolism following total hip arthroplasty and is an important goal of therapy. In response to some of the practical limitations of traditional anticoagulants, a new generation of oral anticoagulants has been developed. These agents include the selective factor Xa inhibitors, rivaroxaban and apixaban, and the direct thrombin inhibitor dabigatran etexilate. The objective of this review article is to update hospitalists on the trial data and clinical considerations surrounding the new anticoagulants. Hospitalists play a key role in caring for surgical patients either in a consultative role or in conjunction with surgical teams. Thus, a practical knowledge of recent developments in thromboprophylaxis is essential for providing high-quality, evidence-based care.