Deep vein thrombosis propylaxis: better living through chemistry-affirms

Increasing numbers of total joint replacement surgeries are being performed in the United States. One of the most frequent complications from these procedures is venous thromboembolism. Prophylaxis is accepted as the standard of care by all the stakeholders: physicians, patient advocacy groups, payers, and government agencies. Debate and disagreement persist with regard to the most clinically efficacious and safe prophylaxis regimen. There are differences between the guideline recommendations from different organizations: American College of Chest Physicians and American Academy of Orthopaedic Surgeons. This review focuses on summarizing some of the differences in the recommended chemoprophylaxis for orthopedic patients undergoing total joint replacement surgery. We have also included a discussion of newer agents in clinical development.