Thromboprophylaxis and orthopaedic surgery: options and current guidelines

Area of Science:

• Orthopaedic Surgery
• Vascular Medicine
• Thrombosis Research

Background:

• Venous thromboembolism (VTE) is a significant risk following orthopaedic procedures, especially total joint arthroplasty (TJA) and hip fracture surgery (HFS).
• Effective thromboprophylaxis is mandatory to mitigate VTE complications, which arise from hypercoagulability, venous stasis, and endothelial damage (Virchow's triad).
• Advances in surgical techniques and peri-operative care necessitate updated VTE prevention strategies.

Purpose of the Study:

• To review current VTE prophylactic options for patients undergoing TJA and HFS.
• To outline best practice guidelines for VTE prevention in lower extremity orthopaedic surgery.
• To discuss the impact of multimodal management on VTE risk.

Main Methods:

• Literature review of VTE prophylaxis in orthopaedic surgery.
• Analysis of current best practice guidelines.
• Discussion of risk factors and prevention strategies.

Main Results:

• Antithrombotic therapy is critical for peri- and post-operative management.
• Optimal thromboprophylaxis is essential to avoid VTE complications.
• Multimodal approaches influence VTE risk after TJA and HFS.

Conclusions:

• Current best practices emphasize a multimodal approach to VTE prevention in TJA and HFS.
• Understanding Virchow's triad remains fundamental to VTE pathogenesis.
• Adherence to guidelines is crucial for reducing VTE incidence in orthopaedic patients.