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Updated: May 25, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Clopidogrel dilemma for orthopaedic surgeons.

Mitchell J Steele¹, John S Fox, John P Fletcher

¹Wollongong Hospital, 4 Mansion Pt Road, Grays Point, Sydney, NSW 2232, Australia. mitchelljsteele@gmail.com

ANZ Journal of Surgery

|February 3, 2012

Summary

Managing clopidogrel in patients undergoing orthopedic surgery is challenging. Continuing clopidogrel perioperatively is recommended when possible to avoid stent thrombosis, with careful bleeding risk assessment and management.

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Last Updated: May 25, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Area of Science:

Orthopaedic Surgery
Cardiology
Pharmacology

Background:

Patients on clopidogrel pose a management challenge for orthopedic surgeons.
Balancing bleeding risks against the risks of discontinuing clopidogrel is crucial.

Purpose of the Study:

To review current evidence on managing clopidogrel in orthopedic surgery.
To guide orthopedic surgeons in perioperative clopidogrel management.

Main Methods:

Literature review of existing evidence on perioperative clopidogrel use.
Assessment of risks associated with continuing or discontinuing clopidogrel.
Consideration of venous thromboprophylaxis.

Main Results:

Limited high-quality evidence exists for perioperative clopidogrel in orthopedic surgery.
Assessed risks include bleeding, stent thrombosis, and venous thromboembolism.
Current practices and blood loss in orthopedic operations were evaluated.

Conclusions:

Continuing clopidogrel perioperatively is preferred, especially for patients with drug-eluting stents, to prevent stent thrombosis.
Careful bleeding risk assessment and management are essential.
A team approach is recommended to individualize patient care and manage perioperative clopidogrel therapy.