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Venous thromboembolism following total knee replacement
1Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX 75390-8883, USA.
Abstract:
Venous thromboembolic disease (VTE) remains the most common and potentially fatal complication following total knee replacement (TKR). Its incidence has been reported in excess of 50% if no prophylaxis is used. Even with current prophylaxis regimens, VTE incidence remains high in the range of 25% to 30%. Three prophylaxis regimens are recommended according to the guidelines put forth by the American College of Chest Physicians: 1) low-molecular-weight heparin, 2) indirect factor Xa inhibitor, and 3) adjusted-dose warfarin. Phase II and III clinical trials are currently underway to evaluate the efficacy and safety of newer antithrombotic agents as prophylaxis against VTE following TKR.
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