Perioperative Management of Chronic Antithrombotic Agents in Elective Hip and Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Cardiology
• Hematology

Background:

• Total hip and knee arthroplasty (TJA) are increasingly common orthopedic procedures.
• Many TJA patients use chronic antithrombotic agents for conditions like atrial fibrillation or acute coronary syndrome.
• Perioperative antithrombotic management is critical due to bleeding risks from TJA and thromboembolic risks post-surgery.

Purpose of the Study:

• To provide an overview of current society guidelines for perioperative antithrombotic management in elective TJA.
• To summarize recent literature relevant to informing future guidelines on antithrombotic management.
• To emphasize the importance of patient-specific, multidisciplinary approaches to antithrombotic therapy.

Main Methods:

• Review of existing society guidelines on perioperative antithrombotic management for TJA.
• Synthesis of recent scientific literature concerning antithrombotic therapy in the context of TJA.
• Consultation with cardiology, internal medicine, and hematology specialists.

Main Results:

• Established guidelines offer frameworks for managing antithrombotic agents during TJA.
• Recent literature highlights evolving strategies and considerations for perioperative antithrombotic use.
• A patient-specific approach, involving multiple medical specialties, is essential for optimal outcomes.

Conclusions:

• Perioperative antithrombotic management in TJA requires careful consideration of bleeding and thromboembolic risks.
• Adherence to guidelines and incorporation of recent literature are vital for safe and effective patient care.
• Collaborative, patient-centered decision-making among various medical specialists ensures optimal management of antithrombotic regimens.