The Journal of Arthroplasty
Volume 27, Issue 2 , Pages 167-172 , February 2012

Pulmonary Embolism Prophylaxis in More Than 30,000 Total Knee Arthroplasty Patients: Is There a Best Choice?

  • Monti Khatod, MD

      Affiliations

    • Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Baldwin Park, California
    • Corresponding Author InformationReprint requests: Monti Khatod, MD, Department of Orthopaedic Surgery, Kaiser Permanente Baldwin Park, 1011 Baldwin Park Blvd. Baldwin Park, CA 91706.
  • ,
  • Maria C.S. Inacio, MS

      Affiliations

    • Department of Surgical Outcomes and Analysis, Southern California Permanente Medical Group, San Diego, California
  • ,
  • Stefano A. Bini, MD

      Affiliations

    • Department of Orthopaedic Surgery, The Permanente Medical Group, Oakland, California
  • ,
  • Elizabeth W. Paxton, MA

      Affiliations

    • Department of Surgical Outcomes and Analysis, Southern California Permanente Medical Group, San Diego, California

Received 19 January 2011 ,Accepted 2 April 2011.

References 

  1. Harris WH, Sledge CB. Total hip and total knee replacement (2). N Engl J Med. 1990;323:801
  2. Liang MH, Cullen KE, Larson MG, et al. Cost-effectiveness of total joint arthroplasty in osteoarthritis. Arthritis Rheum. 1986;29:937
  3. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:381S
  4. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S
  5. Eikelboom JW, Karthikeyan G, Fagel N, et al. American Association of Orthopedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients?. Chest. 2009;135:513
  6. Guideline on the Prevention of Symptomatic Pulmonary Embolism in Patients Undergoing Total Hip or Knee Arthroplasty. 2007. (Accessed November 30th, 2009, at http://www.aaos.org/research/guidelines/PEguide.asp.)
  7. NIH Consensus Statement on total knee replacement December 8-10, 2003. J Bone Joint Surg Am. 2004;86-A:1328
  8. Specifications Manual for National Hospital Inpatient Quality Measures Discharges 04-01-09 (2Q09) through 09-30-09 (Q309) which is Section 2.4. Center for Medicare and Medicaid Service and The Joint Commission, 2009. (Accessed November 30th, 2009, at http://www.jointcommission.org/PerformanceMeasurement/PerformanceMeasurement/Current+NHQM+Manual.htm.)
  9. Paxton EW, Inacio MC, Khatod M, et al. Kaiser Permanente National Total Joint Replacement Registry: aligning operations with information technology. Clin Orthop Relat Res. 2010;468:2646
  10. AHRQ . Agency for healthcare research and quality, quality indicators. In: Patient safety indicators download. 2007;
  11. Henderson KE, Recktenwald A, Reichley RM, et al. Clinical validation of the AHRQ postoperative venous thromboembolism patient safety indicator. Jt Comm J Qual Patient Saf. 2009;35:370
  12. Zhan C, Battles J, Chiang YP, et al. The validity of ICD-9-CM codes in identifying postoperative deep vein thrombosis and pulmonary embolism. Jt Comm J Qual Patient Saf. 2007;33:326
  13. Khatod M, Inacio M, Paxton EW, et al. Knee replacement: epidemiology, outcomes, and trends in Southern California: 17,080 replacements from 1995 through 2004. Acta Orthop. 2008;79:812
  14. Hodge WA. Prevention of deep vein thrombosis after total knee arthroplasty. Coumadin versus pneumatic calf compression. Clin Orthop Relat Res. 1991;101
  15. Haas SB, Insall JN, Scuderi GR, et al. Pneumatic sequential-compression boots compared with aspirin prophylaxis of deep-vein thrombosis after total knee arthroplasty. J Bone Joint Surg Am. 1990;72:27
  16. Westrich GH, Bottner F, Windsor RE, et al. VenaFlow plus Lovenox vs VenaFlow plus aspirin for thromboembolic disease prophylaxis in total knee arthroplasty. J Arthroplasty. 2006;21:139
  17. Hooker JA, Lachiewicz PF, Kelley SS. Efficacy of prophylaxis against thromboembolism with intermittent pneumatic compression after primary and revision total hip arthroplasty. J Bone Joint Surg Am. 1999;81:690
  18. Lachiewicz PF, Soileau ES. Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res. 2006;453:225
  19. Lieberman JR, Huo MM, Hanway J, et al. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am. 1994;76:341
  20. Westrich GH, Sculco TP. Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone. J Bone Joint Surg Am. 1996;78:826
  21. Hawker GA, Coyte PC, Wright JG, et al. Accuracy of administrative data for assessing outcomes after knee replacement surgery. J Clin Epidemiol. 1997;50:265
  22. Burnett RS, Clohisy JC, Wright RW, et al. Failure of the American College of Chest Physicians-1A protocol for Lovenox in clinical outcomes for thromboembolic prophylaxis. J Arthroplasty. 2007;22:317

 Source of funding: There was no external funding source.

 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.04.006.

PII: S0883-5403(11)00164-1

doi: 10.1016/j.arth.2011.04.006

The Journal of Arthroplasty
Volume 27, Issue 2 , Pages 167-172 , February 2012