Thromboembolic Complications of Orthopedic Surgery

Orthopedic surgery is a major risk factor for thromboembolic events such as deep venous thrombosis and pulmonary embolism following a variety of surgeries such as total hip and knee replacements, fracture fixations, spinal surgeries, orthopedic traumas, and arthroscopic surgeries. Many other risk factors contribute, such as age, immobilization, combined oral contraceptive medications, genetic causes, cast immobilization, tourniquet use, and comorbidities. Prophylaxis can be done through chemoprophylaxis and/or mechanoprophylaxis. Diagnosis of deep venous thrombosis is made through ultrasonography, and pulmonary embolism diagnosis is made using risk stratification and a variety of possible tests including D-dimer levels, computed tomography pulmonary angiogram, and ventilation/perfusion scans. Treatment requires using anticoagulants for a minimum of 3 months or possibly inferior vena cava filters if anticoagulation therapy is contraindicated.