Multimodal venous thromboembolic disease prevention for patients undergoing primary or revision total joint arthroplasty: the role of aspirin.
Venous thromboembolic disease (VTD), which consists primarily of deep venous thrombosis (DVT) and pulmonary embolism (PE), is of significant concern to orthopedic surgeons who perform total hip and total knee arthroplasties. DVT and PE can be prevented in multiple ways; each method or combination of methods has its benefits and drawbacks. Seemingly, the more efficacious a medication or method for preventing VTD, the higher the associated risk for adverse events such as bleeding and wound complications. For each patient, then, the balance or homeostasis between significant clotting event and bleeding must be determined. Examining this balance and understanding the benefits and risks associated with each medication or intervention may allow surgeons to make educated decisions about prophylaxis for their patients. Furthermore, risk stratification and multimodal management may prove to be the safest and most effective way to manage VTD prevention.
Berend
Keith R
KR
Joint Implant Surgeons, Inc, 7277 Smith's Mill Road, Suite 200, New Albany, OH 43054, USA. berendkr@joint-surgeons.com
Lombardi
Adolph V
AV
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001241:Aspirin / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010690:Phlebography; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D012086:Reoperation; D018570:Risk Assessment; D020246:Venous Thrombosis / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D006493:Heparin; D001241:Aspirin