Current trends for venous thromboembolic prophylaxis for hip arthroscopy: a modified Delphi and nominal group...

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Preventive Medicine

Background:

• Venous thromboembolism (VTE) risk after hip arthroscopy (HA) varies significantly (0.2%-9.5%).
• Current recommendations for VTE prophylaxis in HA patients are scarce.
• Understanding current prophylaxis trends among high-volume surgeons is crucial.

Purpose of the Study:

• To survey high-volume hip arthroscopists regarding their VTE prophylaxis practices.
• To identify trends in chemoprophylaxis and mechanical prophylaxis use.
• To explore expert opinions on VTE risk factors and prophylaxis duration.

Main Methods:

• A combination of nominal group technique (NGT) and modified Delphi consensus methods.
• A preliminary questionnaire followed by NGT discussions.
• A final survey administered to 35 high-volume hip surgeons performing an average of 109 HA procedures annually.

Main Results:

• 91.4% of surgeons use chemoprophylaxis, with aspirin as the universal choice.
• 97.1% administer aspirin for 2-4 weeks postoperatively.
• No consensus was reached on discontinuing oral contraceptives or addressing smoking preoperatively.
• VTE history, hypercoagulable status, and malignancy were identified as key risk factors.

Conclusions:

• High-volume hip arthroscopic surgeons recognize the importance of VTE prophylaxis.
• Aspirin is the predominant chemoprophylaxis agent, typically used for 2-4 weeks.
• Optimal duration and specific protocols for VTE prophylaxis in HA patients require further investigation.