Venous thromboembolism: management by American Association of Hip and Knee Surgeons.
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.
Markel
David C
DC
Department of Orthopaedic Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA.
York
Sally
S
Liston
Michael J
MJ
Flynn
Jeffrey C
JC
Barnes
C Lowry
CL
Davis
Charles M
CM
D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003625:Data Collection; D006801:Humans; D009985:Orthopedics; D011182:Postoperative Care; D011300:Preoperative Care; D018570:Risk Assessment; D012955:Societies, Medical; D014481:United States; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy
D000925:Anticoagulants