Abstract
Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) are major surgical procedures which can cause high morbidity and even mortality. Among these complications is venous thrombo embolism (VTE) comprising deep vien thrombosis (DVT) and pulmonary embolism (PE). Therefore, after these operations, thromboprophylaxis is routinely used. However, it has some complications such as bleeding, adverse effect of chemical agents for using prevention of DVT. Anti-thrombotic prophylaxis includes: low molecular weight heparin (LMWH), fondaparinux, apixaban, dabigatran, rivaroxaban, low dose unfractionated heparin (LDUH), adjusted dose vitamin K antagonist (VKA), aspirin, or mechanical thromboprophylaxis devices. All over the World, orthopaedic surgeons consider a balance between thromboprophylaxis and bleeding. However, it has been still controversy about optimum prophylaxis for DVT. In this current paper, we aimed to review the literature under light of the current studies.
Highlights
As well known by orthopaedic surgeons, Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) areHow to cite this paper: Korucu, I.H., Turkmen, F., Kacira, B., Bilge, O., Kilicaslan, A. and Toker, S. (2014) Thromboprophylaxis for Hip and Knee Arthroplasty: Current Managements and Review of the Literature
American College of Chest Physicians (ACCP) have recommended in patients who have undergone THA or TKA that use of one of the following for a minimum of 10 to 14 days rather than no anti-thrombotic prophylaxis: low molecular weight heparin (LMWH), fondaparinux, apixaban, dabigatran, rivaroxaban, low dose unfractionated heparin (LDUH), adjusted dose vitamin K antagonist (VKA), aspirin, or an intermittent pneumatic compression device (IPCD)
These chemical agents included in guidelines were low molecular weight heparin (LMWH), fondaparinux, apixaban, dabigatran, rivaroxaban, low dose unfractionated heparin (LDUH), adjusted dose vitamin K antagonist (VKA), aspirin
Summary
As well known by orthopaedic surgeons, Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) are. Among these complications is venous thrombo embolism (VTE) comprising deep vien thrombosis (DVT) and pulmonary embolism (PE). While incidence of asymptomatic VTE after these orthopaedic surgeries is about 40% - 60%, symtomatic DVT is 4.3% without any thromboprophylaxis [1] With appropriate thromboprophylaxis these rates are increase 1% 3% incidence of symptomatic DVT and 0.2% - 1.1% incidence of PE [1]. A number of guidelines including American College of Chest Physicians (ACCP) and American Academy of Orthopaedic Surgeons (AAOS) have recommended thromboprophylaxis. All over the World, orthopaedic surgeons consider a balance between thromboprophilaxis and bleeding It has been still controversy about optimum prophylaxis for DVT.
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