Venous Thromboembolism: Management by American Association of Hip and Knee Surgeons

Markel, David C.; York, Sally; Liston, Michael J.; Flynn, Jeffrey C.; Barnes, C. Lowry; Davis, Charles M.; the AAHKS Research Committee,

doi:10.1016/j.arth.2009.07.021

« Previous Next »The Journal of Arthroplasty
Volume 25, Issue 1 , Pages 3-9.e2, January 2010

Venous Thromboembolism:

Management by American Association of Hip and Knee Surgeons

David C. Markel, MD
- Department of Orthopaedic Surgery, Providence Hospital and Medical Centers, Southfield, Michigan
- Detroit Medical Center/Providence Hospital Orthopaedic Residency Program, Detroit, Michigan
- Reprint requests: David C. Markel, MD, Department of Orthopaedic Surgery, Providence Hospital and Medical Centers, Detroit Medical Center/Providence Hospital Orthopaedic Residency Program, 22250 Providence Drive, Suite #401, Southfield, MI 48075.
Sally York, MN
- NorthWest Orthopaedic Institute, Tacoma, Washington
Michael J. Liston Jr, MD
- Detroit Medical Center/Providence Hospital Orthopaedic Residency Program, Detroit, Michigan
Jeffrey C. Flynn, PhD
- Department of Orthopaedic Surgery, Providence Hospital and Medical Centers, Southfield, Michigan
C. Lowry Barnes, MD
- Arkansas Specialty Orthopaedics, Foundation for Musculoskeletal Research and Education, Little Rock, Arkansas
Charles M. Davis III, MD, PhD
- Department of Orthopedic Surgery and Rehabilitation, Pennsylvania State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
the AAHKS Research Committee

Received 12 May 2009; accepted 23 July 2009. published online 19 October 2009.

Abstract

A 2008 survey of American Association of Hip and Knee Surgeons membership explored current venous thromboembolism (VTE) protocols for lower-extremity total joint surgery. Fifty-three percent reported a change in VTE-related practices in the last 5 years. More than 70% reported that their primary hospital now mandates VTE prophylaxis. Although 74% of their primary hospitals recognized the American College of Chest Physicians guidelines, 68% of surgeons felt the American Academy of Orthopaedic Surgeons guidelines were more relevant to their practice. Respondents believe low molecular weight heparin to be the most efficacious but aspirin to be the easiest to use and has the lowest risks of bleeding and wound drainage. Warfarin was the most used in hospital prophylaxis, and 90% of respondents targeted an international normalized ratio of 1.6 to 2.5. Practice patterns continue to evolve, and there remains no consensus on specific treatment protocols or preferences.

Keywords: venous thromboembolism, total hip arthroplasty, total knee arthroplasty, survey, American Association of Hip and Knee Surgeons, treatment