An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020
Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute num...
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doaj-ed0829cf6d184c999b9fc31c6a0c9d322020-11-25T03:42:13ZengMDPI AGMedicina1010-660X2020-08-015641641610.3390/medicina56090416An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020Daniel C. Santana0Ahmed K. Emara1Melissa N. Orr2Alison K. Klika3Carlos A. Higuera4Viktor E. Krebs5Robert M. Molloy6Nicolas S. Piuzzi7Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL 33331, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USAPatients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage.https://www.mdpi.com/1010-660X/56/9/416arthroplastyjoint replacementvenous thromboembolismDVTpulmonary embolismsurgical complications |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Daniel C. Santana Ahmed K. Emara Melissa N. Orr Alison K. Klika Carlos A. Higuera Viktor E. Krebs Robert M. Molloy Nicolas S. Piuzzi |
spellingShingle |
Daniel C. Santana Ahmed K. Emara Melissa N. Orr Alison K. Klika Carlos A. Higuera Viktor E. Krebs Robert M. Molloy Nicolas S. Piuzzi An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 Medicina arthroplasty joint replacement venous thromboembolism DVT pulmonary embolism surgical complications |
author_facet |
Daniel C. Santana Ahmed K. Emara Melissa N. Orr Alison K. Klika Carlos A. Higuera Viktor E. Krebs Robert M. Molloy Nicolas S. Piuzzi |
author_sort |
Daniel C. Santana |
title |
An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 |
title_short |
An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 |
title_full |
An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 |
title_fullStr |
An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 |
title_full_unstemmed |
An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020 |
title_sort |
update on venous thromboembolism rates and prophylaxis in hip and knee arthroplasty in 2020 |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2020-08-01 |
description |
Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage. |
topic |
arthroplasty joint replacement venous thromboembolism DVT pulmonary embolism surgical complications |
url |
https://www.mdpi.com/1010-660X/56/9/416 |
work_keys_str_mv |
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