TY - JOUR
T1 - Venous Thromboembolism Prophylaxis after Total Knee Arthroplasty
AU - Box, Hayden N.
AU - Shahrestani, Sean
AU - Huo, Michael H.
PY - 2018/3/7
Y1 - 2018/3/7
N2 - Venous thromboembolic disease (VTED) is a major cause of morbidity and mortality after total knee arthroplasty (TKA). Current VTED prophylaxis protocols consist of early mobilization, mechanical compression devices, and pharmacologic agents. Venous phasic flow-regulated below-knee devices are generally favored, but the optimal duration and method of mechanical prophylaxis is unknown. Risk stratification models have been developed to guide pharmacologic prophylaxis. For patients with standard VTED risk profile, aspirin has become increasingly popular. Recent studies have validated the efficacy, relatively low bleeding risks, and cost-effectiveness of aspirin in the patients with standard risk profile. Current evidence suggests that the newer oral anticoagulants, including the factor Xa and the direct thrombin inhibitors, are effective for the reduction of postoperative VTED but may be associated with increased bleeding and wound complication rates.
AB - Venous thromboembolic disease (VTED) is a major cause of morbidity and mortality after total knee arthroplasty (TKA). Current VTED prophylaxis protocols consist of early mobilization, mechanical compression devices, and pharmacologic agents. Venous phasic flow-regulated below-knee devices are generally favored, but the optimal duration and method of mechanical prophylaxis is unknown. Risk stratification models have been developed to guide pharmacologic prophylaxis. For patients with standard VTED risk profile, aspirin has become increasingly popular. Recent studies have validated the efficacy, relatively low bleeding risks, and cost-effectiveness of aspirin in the patients with standard risk profile. Current evidence suggests that the newer oral anticoagulants, including the factor Xa and the direct thrombin inhibitors, are effective for the reduction of postoperative VTED but may be associated with increased bleeding and wound complication rates.
KW - total knee arthroplasty
KW - total knee arthroplasty complications
KW - venous thromboembolism prophylaxis
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U2 - 10.1055/s-0038-1636907
DO - 10.1055/s-0038-1636907
M3 - Article
C2 - 29514375
AN - SCOPUS:85043336589
SN - 1538-8506
JO - Journal of Knee Surgery
JF - Journal of Knee Surgery
ER -