Chemical thromboprophylaxis in total knee replacement: A critical review

Abstract

Venous thromboembolism (VTE) remains a devastating and potentially lethal complication following total knee replacement (TKR) surgery. Studies have shown that 40%–85% of patients develop venographically confirmed deep vein thrombosis after TKA if they do not receive any form of thromboprophylaxis (TP), and approximately 0.1%–1.7% also suffer from fatal complication such as pulmonary embolism (PE). There are various chemical-TP (CTP) recommendations in the literature for patients having TKR surgery. The present review provides the current evidence for CTP in post-TKR surgery. All guidelines provided by the American Academy of Orthopedic Surgeons, American College of Chest Physicians, and National Institute for Health and Clinical Excellence are reviewed and analyzed in detail. Newer oral anticoagulants results are also studied as well, in the quest for an effective and safe VTE prophylaxis after TKR surgery.

Keywords

• chemical prophylaxis
• deep vein thrombosis
• guidelines
• pulmonary embolism
• thromboprophylaxis
• total knee replacement
• venous thromboembolism