Prophylaxis for Deep Venous Thrombosis After Joint Replacement Surgery

Prophylaxis for Deep Venous Thrombosis After Joint Replacement Surgery

Dr. Tan and coauthors from the Rothman Clinic presented their results at the 25th anniversary of the American Association of hip and knee surgeons in Dallas, Texas November 2015, looking at a multicenter study of 63,526 primary and revision joint replacements. In low risk patients, they found the incidence of lower extremity blood clots using aspirin to be the lowest at 0.17%. In high-risk individuals (those with prior DVT history of clotting or other factors that make them high risk) the incidence of lower extremity blood clots using aspirin was 1.5% versus 3.48% for more potent anticoagulation agents. They concluded that high-risk patients can be adequately prophylaxed with aspirin to try and prevent postoperative blood clots. Further work on this subject needs to be performed before there is overall consensus with this recommendation.

It should be noted that in patients who had no prior blood clots in their lower extremities and do not have some genetic preponderance to lower extremity blood clots, aspirin is evolving to be the most common form of prophylaxis after hip and knee replacement surgery.

About The Author

William Barrett, MD is a fellowship trained orthopedic surgeon who specializes in primary and revision hip and knee replacement. He performs over 500 hip and knee replacement procedures each year. He is actively involved in clinical research on Anterior Approach Total Hip Replacement (THA), Alternative Bearings for THA, Less Invasive Approaches to joint replacement and use of computerized vs. custom cutting guides for knee replacement. As a nationally recognized joint replacement surgeon, he lectures globally on hip and knee replacement topics. He is active in the American Academy of Orthopaedic Surgeons Continuing Medical Education programs. He is a board examiner for the American Board of Orthopaedic Surgery.