title: Clinical Performance of the 1st American Academy of Orthopaedic Surgeons Clinical Guideline on Prevention of Symptomatic Pulmonary Embolism after Total Knee Arthroplasty in Korean Patients.
abstract: We sought to document the clinical performance of the 1st American Academy of Orthopaedic Surgeons (AAOS) guideline on the prevention of symptomatic pulmonary embolism (PE) after total knee arthroplasty (TKA) in Korean patients, in terms of the proportions of the each risk-stratified group, efficacy and safety. Consecutive 328 patients underwent TKA were preoperatively assessed for the risks of PE and bleeding and categorized into 4 groups: 1) standard risk, 2) high risk for PE, 3) high risk for bleeding, and 4) high risks both for PE and bleeding. One of three options was administered according to the groups (aspirin in group 1 or 4; enoxaparin and following aspirin in group 2; antithrombotic stocking in group 3). Incidences of symptomatic deep vein thrombosis (DVT) and PE, and major or minor bleeding complications were evaluated. Majority of the patients (86%) were assessed to be with standard risks both for PE and bleeding. No patient experienced symptomatic DVT or PE and major bleeding. Eleven percent of the patients discontinued chemoprophylaxis because of bleeding-related wound complication. In conclusion, the 1st AAOS guideline functions successfully in Korean patients undergoing TKA in terms of prevention of symptomatic DVT and PE while avoiding major bleeding complications.
authors.affiliation: Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young Gon
authors.identifier: 0000-0003-2723-4328
authors.initials: YG
authors.lastname: Na
authors.affiliation: Department of Orthopedic Surgery, Xinjiang Medical University, Urumqi, Xinjiang, China.
authors.forename: Rui
authors.identifier: 0000-0002-2447-4687
authors.initials: R
authors.lastname: Fang
authors.affiliation: Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yeon Ho
authors.identifier: 0000-0002-5175-0018
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kwan Jae
authors.identifier: 0000-0001-5599-563X
authors.initials: KJ
authors.lastname: Cho
authors.affiliation: Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Tae Kyun
authors.identifier: 0000-0001-6345-4227
authors.initials: TK
authors.lastname: Kim
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage; D015331:Cohort Studies; D017984:Enoxaparin / Q000008:administration & dosage; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012955:Societies, Medical; D053828:Stockings, Compression; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents; D001241:Aspirin
keywords: AAOS Guideline; Arthroplasty, Replacement, Knee; Aspirin; Chemoprevention; Enoxaparin; Hemorrhage; Pulmonary Embolism; Venous Thromboembolism; Venous Thrombosis