TY - JOUR
T1 - Venous thromboembolism (VTE) prophylaxis for hip and knee arthroplasty
T2 - Changing trends
AU - Budhiparama, Nicolaas C.
AU - Abdel, Matthew P.
AU - Ifran, Nadia N.
AU - Parratte, Sébastien
N1 - Funding Information:
Conflict of Interest Nicolaas C. Budhiparama is a consultant for DePuy J&J Stryker, Sanofi Aventis, Pfizer Asia and Bayer. He has received a research grant from Bayer; education grants from DePuy J&J Stryker, Pfizer, and Zimmer. Matthew P. Abdel declares that he has no conflict of interest. Nadia N. Ifran declares that she has no conflict of interest.
PY - 2014/6
Y1 - 2014/6
N2 - Venous thromboembolism (VTE) has been identified as an immediate threat to patients undergoing major orthopedic procedures such as total hip arthroplasty (THA) and total knee arthroplasty (TKA). Given the known dangers of VTE, arthroplasty surgeons are sensitive to the need for VTE thromboprophylaxis. However, the modalities of thromboprophylaxis used to minimize the risks to patients have been variable. Clinical practice guidelines have been published by several professional organizations, while some hospitals have established their own protocols. The 2 most popular guidelines are those published by the Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP), both from North America. Prior to 2012, these recommendations varied depending on underlying definitions, methodology, and goals of the 2 groups. For the first time, both groups have similar recommendations that focus on minimizing symptomatic VTE and bleeding complications. The key to determining the appropriate chemoprophylaxis for patients is to balance efficacy of a prophylactic agent, while being safe in regards to bleeding complications. However, a multimodal approach that focuses on early postoperative mobilization and the use of mechanical prophylaxis, in addition to chemoprophylaxis, is essential.
AB - Venous thromboembolism (VTE) has been identified as an immediate threat to patients undergoing major orthopedic procedures such as total hip arthroplasty (THA) and total knee arthroplasty (TKA). Given the known dangers of VTE, arthroplasty surgeons are sensitive to the need for VTE thromboprophylaxis. However, the modalities of thromboprophylaxis used to minimize the risks to patients have been variable. Clinical practice guidelines have been published by several professional organizations, while some hospitals have established their own protocols. The 2 most popular guidelines are those published by the Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP), both from North America. Prior to 2012, these recommendations varied depending on underlying definitions, methodology, and goals of the 2 groups. For the first time, both groups have similar recommendations that focus on minimizing symptomatic VTE and bleeding complications. The key to determining the appropriate chemoprophylaxis for patients is to balance efficacy of a prophylactic agent, while being safe in regards to bleeding complications. However, a multimodal approach that focuses on early postoperative mobilization and the use of mechanical prophylaxis, in addition to chemoprophylaxis, is essential.
KW - Chemical prophylaxis
KW - Clinical guidelines
KW - Deep vein thrombosis (DVT)
KW - Hip
KW - Knee
KW - Mechanical prophylaxis
KW - Prophylaxis
KW - Pulmonary embolism(PE)
KW - Thromboprophylaxis
KW - Total joint arthroplasty
KW - Venous thromboembolism(VTE)
UR - http://www.scopus.com/inward/record.url?scp=84905730763&partnerID=8YFLogxK
U2 - 10.1007/s12178-014-9207-1
DO - 10.1007/s12178-014-9207-1
M3 - Article
AN - SCOPUS:84905730763
SN - 1935-973X
VL - 7
SP - 108
EP - 116
JO - Current Reviews in Musculoskeletal Medicine
JF - Current Reviews in Musculoskeletal Medicine
IS - 2
ER -