The Australian Arthroplasty Thromboprophylaxis Survey

Abstract 

Previous surveys of orthopedic surgeons have shown considerable variation in thromboprophylaxis for venous thromboembolism after joint arthroplasty. This survey aimed to determine the current practice among Australian orthopedic surgeons. A questionnaire regarding the duration, reasons, and methods of chemical and mechanical prophylaxis for hip and knee arthroplasty patients was sent to the 1082 surgeons identified; 593 (55%) members completed the questionnaire. The survey revealed that 98% of surgeons used chemical thromboprophylaxis, mainly low-molecular-weight heparin (84% hip and 79% knee). Those who use low-molecular-weight heparin were more likely to prescribe anticoagulants in fear of litigation (19.2% vs 10.1%, P = .04) and more likely to rely on protocols or guidelines (32.2% vs 17.2%, P = .004) instead of basing their decision on their own reading (52.4% vs 71.3%, P = .001). Most orthopedic surgeons in our survey have indicated that they would welcome guidelines from their association or college regarding thromboprophylaxis in arthroplasty.

Keywords: total joint replacement, thromboprophylaxis, venous thromboembolism, anticoagulants