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Venous Thromboembolism and Orthopedic Surgery

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Abstract

Thromboembolic events are common and feared complications of orthopedic surgery, particularly lower extremity arthroplasty. Both patient and procedure-related risk factors have been identified. Prevention, an important tenant of orthopedic care, involves pharmacologic, nonpharmacologic approaches. This chapter presents a general overview of the problem of thromboembolism in the orthopedic setting.

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References

  1. Kim J, Kraft P, Hagan KA, Harrington LB, Lindstroem S, Kabrhel C. Interaction of a genetic risk score with physical activity, physical inactivity, and body mass index in relation to venous thromboembolism risk. Genet Epidemiol. 2018;42(4):354–65.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Delluc A, Gourhant L, Lacut K, Mercier B, Audrezet M, Nowak E, et al. Association of common genetic variations and idiopathic venous thromboembolism. Results from EDITh, a hospital-based case-control study. Thromb Haemost. 2010;103(6):1161–9.

    Article  CAS  PubMed  Google Scholar 

  3. Crous-Bou M, Harrington LB, Kabrhel C. Environmental and genetic risk factors associated with venous thromboembolism. Semin Thromb Hemost. 2016;42(8):808–20.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Margaglione M, Grandone E. Population genetics of venous thromboembolism. A narrative review. Thromb Haemost. 2011;105(2):221–31.

    Article  CAS  PubMed  Google Scholar 

  5. Rosendaal FR, Reitsma PH. Genetics of venous thrombosis. J Thromb Haemost. 2009;7 Suppl 1:301–4.

    Article  CAS  PubMed  Google Scholar 

  6. Zhou X, Qian W, Li J, Zhang P, Yang Z, Chen W, et al. Who are at risk for thromboembolism after arthroplasty? A systematic review and meta-analysis. Thromb Res. 2013;132(5):531–6.

    Article  CAS  PubMed  Google Scholar 

  7. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):3–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Newman JM, Abola MV, Macpherson A, Klika AK, Barsoum WK, Higuera CA. ABO blood group is a predictor for the development of venous thromboembolism after total joint arthroplasty. J Arthroplast. 2017;32(9S):S258.

    Google Scholar 

  9. Imberti D, Bianchi C, Zambon A, Parodi A, Merlino L, Gallerani M, et al. Venous thromboembolism after major orthopaedic surgery: a population-based cohort study. Intern Emerg Med. 2012;7(3):243–9.

    Article  PubMed  Google Scholar 

  10. Memtsoudis S, Liu SS, Ma Y, Chiu YL, Walz JM, Gaber-Baylis LK, et al. Perioperative pulmonary outcomes in patients with sleep apnea after noncardiac surgery. Anesth Analg. 2011;112(1):113–21.

    Article  PubMed  Google Scholar 

  11. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007;44(2):62–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease. Semin Hematol. 2001;38(2 Suppl 5):12–9.

    Article  CAS  PubMed  Google Scholar 

  13. Lassen MR, Ageno W, Borris LC, Lieberman JR, Rosencher N, Bandel TJ, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358(26):2776–86.

    Article  CAS  PubMed  Google Scholar 

  14. White RH, Zhou H, Romano PS. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures. Thromb Haemost. 2003;90(3):446–55.

    CAS  PubMed  Google Scholar 

  15. Albayati MA, Grover SP, Saha P, Lwaleed BA, Modarai B, Smith A. Postsurgical inflammation as a causative mechanism of venous thromboembolism. Semin Thromb Hemost. 2015;41(6):615–20.

    Article  PubMed  Google Scholar 

  16. Dahl OE, Pedersen T, Kierulf P, Westvik AB, Lund P, Arnesen H, et al. Sequential intrapulmonary and systemic activation of coagulation and fibrinolysis during and after total hip replacement surgery. Thromb Res. 1993;70(6):451–8.

    Article  CAS  PubMed  Google Scholar 

  17. Sharrock NE, Go G, Harpel PC, Ranawat CS, Sculco TP, Salvati EA. The John Charnley Award. Thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res. 1995;319:16–27.

    Google Scholar 

  18. Nishiguchi M, Takamura N, Abe Y, Kono M, Shindo H, Aoyagi K. Pilot study on the use of tourniquet: a risk factor for pulmonary thromboembolism after total knee arthroplasty? Thromb Res. 2005;115(4):271–6.

    Article  CAS  PubMed  Google Scholar 

  19. Turan A, Bajracharya GR, Leung S, Yazici Kara M, Mao G, Botsford T, et al. Association of neuraxial anesthesia with postoperative venous thromboembolism after noncardiac surgery: a propensity-matched analysis of ACS-NSQIP database. Anesth Analg. 2019;128(3):494–501.

    Article  CAS  PubMed  Google Scholar 

  20. Memtsoudis SG, González Della Valle A, Besculides MC, Gaber L, Sculco TP. In-hospital complications and mortality of unilateral, bilateral, and revision TKA: based on an estimate of 4,159,661 discharges. Clin Orthop Relat Res. 2008;466(11):2617–27.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Memtsoudis SG, Mantilla CB, Parvizi J, Stundner O, Mazumdar M. Have bilateral total knee arthroplasties become safer? A population-based trend analysis. Clin Orthop Relat Res. 2013;471(1):17–25.

    Article  PubMed  Google Scholar 

  22. Restrepo C, Parvizi J, Dietrich T, Einhorn TA. Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am. 2007;89(6):1220–6.

    Article  PubMed  Google Scholar 

  23. Bounameaux H, Miron MJ, Blanchard J, de Moerloose P, Hoffmeyer P, Leyvraz PF. Measurement of plasma D-dimer is not useful in the prediction or diagnosis of postoperative deep vein thrombosis in patients undergoing total knee arthroplasty. Blood Coagul Fibrinolysis. 1998;9(8):749–52.

    Article  CAS  PubMed  Google Scholar 

  24. Sugimoto E, Kuroda T, Fujita Y, Namba Y, Mitani S. D-dimer testing cannot rule out thromboembolism after major lower extremity arthroplasties and thromboprophylaxis treatment. J Anesth. 2015;29(5):686–9.

    Article  PubMed  Google Scholar 

  25. Kearon C, Julian JA, Newman TE, Ginsberg JS. Noninvasive diagnosis of deep venous thrombosis. McMaster diagnostic imaging practice guidelines initiative. Ann Intern Med. 1998;128(8):663–77.

    Article  CAS  PubMed  Google Scholar 

  26. Hull R, Hirsh J, Sackett DL, Powers P, Turpie AG, Walker I, et al. N Engl J Med. 1977;296(26):1497–500.

    Article  CAS  PubMed  Google Scholar 

  27. Palareti G, Cosmi B, Legnani C. Diagnosis of deep vein thrombosis. Semin Thromb Hemost. 2006;32(7):659–72.

    Article  PubMed  Google Scholar 

  28. Song K, Xu Z, Rong Z, Yang X, Yao Y, Shen Y, et al. The incidence of venous thromboembolism following total knee arthroplasty: a prospective study by using computed tomographic pulmonary angiography in combination with bilateral lower limb venography. Blood Coagul Fibrinolysis. 2016;27(3):266–9.

    Article  PubMed  Google Scholar 

  29. van der Hulle T, Cheung WY, Kooij S, Beenen LFM, van Bemmel T, van Es J, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet. 2017;390(10091):289–97.

    Article  PubMed  Google Scholar 

  30. Pena E, Kimpton M, Dennie C, Peterson R, LE Gal G, Carrier M. Difference in interpretation of computed tomography pulmonary angiography diagnosis of subsegmental thrombosis in patients with suspected pulmonary embolism. J Thromb Haemost. 2012;10(3):496–8.

    Article  CAS  PubMed  Google Scholar 

  31. Carrier M, Righini M, Wells PS, Perrier A, Anderson DR, Rodger MA, et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta-analysis of the management outcome studies. J Thromb Haemost. 2010;8(8):1716–22.

    Article  CAS  PubMed  Google Scholar 

  32. den Exter PL, van Es J, Klok FA, Kroft LJ, Kruip Marieke JHA, Kamphuisen PW, et al. Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism. Blood. 2013;122(7):1149; quiz 1329.

    Google Scholar 

  33. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149(2):315–52.

    Article  PubMed  Google Scholar 

  34. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):453S.

    Google Scholar 

  35. Lotke PA, Palevsky H, Keenan AM, Meranze S, Steinberg ME, Ecker ML, et al. Aspirin and warfarin for thromboembolic disease after total joint arthroplasty. Clin Orthop Relat Res. 1996;324:251–8.

    Article  Google Scholar 

  36. Haas SB, Tribus CB, Insall JN, Becker MW, Windsor RE. The significance of calf thrombi after total knee arthroplasty. J Bone Joint Surg Br. 1992;74(6):799–802.

    Article  CAS  PubMed  Google Scholar 

  37. Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest. 2009 Feb;135(2):513–20.

    Article  PubMed  Google Scholar 

  38. AAOS. We recommend against routine post-operative duplex ultrasonography screening of patients who undergo elective hip or knee arthroplasty. 2015.; Available at: http://www.orthoguidelines.org/guideline-detail?id=1065. Accessed 03 May 2018.

  39. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e325S.

    Google Scholar 

  40. Kearon C. Noninvasive diagnosis of deep vein thrombosis in postoperative patients. Semin Thromb Hemost. 2001;27(1):3–8.

    Article  CAS  PubMed  Google Scholar 

  41. Leclerc JR, Gent M, Hirsh J, Geerts WH, Ginsberg JS. The incidence of symptomatic venous thromboembolism during and after prophylaxis with enoxaparin: a multi-institutional cohort study of patients who underwent hip or knee arthroplasty. Canadian Collaborative Group. Arch Intern Med. 1998;158(8):873–8.

    Article  CAS  PubMed  Google Scholar 

  42. Robinson KS, Anderson DR, Gross M, Petrie D, Leighton R, Stanish W, et al. Ultrasonographic screening before hospital discharge for deep venous thrombosis after arthroplasty: the post-arthroplasty screening study. A randomized, controlled trial. Ann Intern Med. 1997;127(6):439–45.

    Article  CAS  PubMed  Google Scholar 

  43. Elbuluk AM, Kim KY, Chen KK, Anoushiravani AA, Schwarzkopf R, Iorio R. Respiratory synchronized versus intermittent pneumatic compression in prevention of venous thromboembolism after total joint arthroplasty: a systematic review and meta-analysis. Orthop Clin North Am. 2018;49(2):123–33.

    Article  PubMed  Google Scholar 

  44. Hardwick ME, Pulido PA, Colwell CW. A mobile compression device compared with low-molecular-weight heparin for prevention of venous thromboembolism in total hip arthroplasty. Orthop Nurs. 2011;30(5):312–6.

    Article  PubMed  Google Scholar 

  45. Eisele R, Kinzl L, Koelsch T. Rapid-inflation intermittent pneumatic compression for prevention of deep venous thrombosis. J Bone Joint Surg Am. 2007;89(5):1050–6.

    Article  CAS  PubMed  Google Scholar 

  46. Pagella P, Cipolle M, Sacco E, Matula P, Karoly E, Bokovoy J. A randomized trial to evaluate compliance in terms of patient comfort and satisfaction of two pneumatic compression devices. Orthop Nurs. 2007;26(3):169–74.

    Article  PubMed  Google Scholar 

  47. Edwards JZ, Pulido PA, Ezzet KA, Copp SN, Walker RH, Colwell CW. Portable compression device and low-molecular-weight heparin compared with low-molecular-weight heparin for thromboprophylaxis after total joint arthroplasty. J Arthroplast. 2008;23(8):1122–7.

    Article  Google Scholar 

  48. Nakamura M, Kamei M, Bito S, Migita K, Miyata S, Kumagai K, et al. Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty: Secondary analysis of a J-PSVT cohort study on anesthesia. Medicine (Baltimore). 2017;96(18):e6748.

    Article  CAS  Google Scholar 

  49. Haas S, Holberg G, Kreutz R, Lassen MR, Mantovani L, Haupt V, et al. The effects of timing of prophylaxis, type of anesthesia, and use of mechanical methods on outcome in major orthopedic surgery – subgroup analyses from 17,701 patients in the XAMOS study. Vasc Health Risk Manag. 2016;12:209–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Rosencher N, Noack H, Feuring M, Clemens A, Friedman RJ, Eriksson BI. Type of anaesthesia and the safety and efficacy of thromboprophylaxis with enoxaparin or dabigatran etexilate in major orthopaedic surgery: pooled analysis of three randomized controlled trials. Thromb J. 2012;10(1):9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e496S.

    Google Scholar 

  52. Mismetti P, Laporte S, Pellerin O, Ennezat P, Couturaud F, Elias A, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA. 2015;313(16):1627–35.

    Article  PubMed  Google Scholar 

  53. Bass AR, Mattern CJ, Voos JE, Peterson MG, Trost DW. Inferior vena cava filter placement in orthopedic surgery. Am J Orthop (Belle Mead NJ). 2010;39(9):435–9.

    Google Scholar 

  54. Stern JR, Cafasso DE, Meltzer AJ, Schneider DB, Ellozy SH, Connolly PH. Prophylactic inferior vena cava filter utilization and risk factors for nonretrieval. Vasc Endovasc Surg. 2018;52(1):34–8.

    Article  Google Scholar 

  55. Young T, Tang H, Hughes R. Vena caval filters for the prevention of pulmonary embolism. Cochrane Database Syst Rev. 20107;2:CD006212.

    Google Scholar 

  56. Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med. 1998;338(7):409–15.

    Article  CAS  PubMed  Google Scholar 

  57. Shah M, Alnabelsi T, Patil S, Reddy S, Patel B, Lu M, et al. IVC filters-Trends in placement and indications, a study of 2 populations. Medicine (Baltimore). 2017;96(12):e6449.

    Article  PubMed Central  Google Scholar 

  58. Anderson FA, Huang W, Friedman RJ, Kwong LM, Lieberman JR, Pellegrini VD, et al. Prevention of venous thromboembolism after hip or knee arthroplasty: findings from a 2008 survey of US orthopedic surgeons. J Arthroplast. 2012;27(5):666.e5.

    Article  Google Scholar 

  59. Berry DJ, Bozic KJ. Current practice patterns in primary hip and knee arthroplasty among members of the American Association of Hip and Knee Surgeons. J Arthroplast. 2010;25(6 Suppl):2–4.

    Article  Google Scholar 

  60. Shehab N, Lovegrove MC, Geller AI, Rose KO, Weidle NJ, Budnitz DS. US emergency department visits for outpatient adverse drug events, 2013–2014. JAMA. 2016;316(20):2115–25.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Anderson DR, Wilson SJ, Blundell J, Petrie D, Leighton R, Stanish W, et al. Comparison of a nomogram and physician-adjusted dosage of warfarin for prophylaxis against deep-vein thrombosis after arthroplasty. J Bone Joint Surg Am. 2002;84-A(11):1992–7.

    Article  Google Scholar 

  62. Asnis PD, Gardner MJ, Ranawat A, Leitzes AH, Peterson MGE, Bass AR. The effectiveness of warfarin dosing from a nomogram compared with house staff dosing. J Arthroplast. 2007;22(2):213–8.

    Article  Google Scholar 

  63. Gage BF, Bass AR, Lin H, Woller SC, Stevens SM, Al-Hammadi N, et al. Effect of genotype-guided warfarin dosing on clinical events and anticoagulation control among patients undergoing hip or knee arthroplasty: the GIFT randomized clinical trial. JAMA. 2017;318(12):1115–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373(9):823–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Working Party, Association of Anaesthetists of Great Britain & Ireland, Obstetric Anaesthetists’ Association, Regional Anaesthesia UK. Regional anaesthesia and patients with abnormalities of coagulation: the Association of Anaesthetists of Great Britain & Ireland The Obstetric Anaesthetists’ Association Regional Anaesthesia UK. Anaesthesia. 2013;68(9):966–72.

    Article  Google Scholar 

  66. Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35(1):64–101.

    Article  CAS  PubMed  Google Scholar 

  67. Uchino K, Hernandez AV. Dabigatran association with higher risk of acute coronary events: meta-analysis of noninferiority randomized controlled trials. Arch Intern Med. 2012;172(5):397–402.

    Article  CAS  PubMed  Google Scholar 

  68. Adam SS, McDuffie JR, Lachiewicz PF, Ortel TL, Williams JW. Comparative effectiveness of new oral anticoagulants and standard thromboprophylaxis in patients having total hip or knee replacement: a systematic review. Ann Intern Med. 2013;159(4):275–84.

    Article  PubMed  Google Scholar 

  69. Rose DK, Bar B. Direct oral anticoagulant agents: pharmacologic profile, indications, coagulation monitoring, and reversal agents. J Stroke Cerebrovasc Dis. 2018;27(8):2049–58.

    Article  PubMed  Google Scholar 

  70. Tornkvist M, Smith JG, Labaf A. Current evidence of oral anticoagulant reversal: a systematic review. Thromb Res. 2018;162:22–31.

    Article  CAS  PubMed  Google Scholar 

  71. Holzmacher JL, Sarani B. Indications and methods of anticoagulation reversal. Surg Clin North Am. 2017;97(6):1291–305.

    Article  PubMed  Google Scholar 

  72. Salvati EA, Sharrock NE, Westrich G, Potter HG, Valle AGD, Sculco TP. The 2007 ABJS Nicolas Andry Award: three decades of clinical, basic, and applied research on thromboembolic disease after THA: rationale and clinical results of a multimodal prophylaxis protocol. Clin Orthop Relat Res. 2007;459:246–54.

    Article  PubMed  Google Scholar 

  73. Lalmohamed A, Vestergaard P, de Boer A, Leufkens HGM, van Staa TP, de Vries F. Changes in mortality patterns following total hip or knee arthroplasty over the past two decades: a nationwide cohort study. Arthritis Rheum (Hoboken, NJ). 2014;66(2):311–8.

    Article  Google Scholar 

  74. Kulshrestha V, Kumar S. DVT prophylaxis after TKA: routine anticoagulation vs risk screening approach – a randomized study. J Arthroplast. 2013;28(10):1868–73.

    Article  Google Scholar 

  75. Zou Y, Tian S, Wang Y, Sun K. Administering aspirin, rivaroxaban and low-molecular-weight heparin to prevent deep venous thrombosis after total knee arthroplasty. Blood Coagul Fibrinolysis. 2014;25(7):660–4.

    Article  CAS  PubMed  Google Scholar 

  76. Sharrock NE, Gonzalez Della Valle A, Go G, Lyman S, Salvati EA. Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clin Orthop Relat Res. 2008;466(3):714–21.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Sobieraj DM, Lee S, Coleman CI, Tongbram V, Chen W, Colby J, et al. Prolonged versus standard-duration venous thromboprophylaxis in major orthopedic surgery: a systematic review. Ann Intern Med. 2012;156(10):720–7.

    Article  PubMed  Google Scholar 

  78. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000;355(9212):1295–302.

    Google Scholar 

  79. Westrich GH, Bottner F, Windsor RE, Laskin RS, Haas SB, Sculco TP. VenaFlow plus Lovenox vs VenaFlow plus aspirin for thromboembolic disease prophylaxis in total knee arthroplasty. J Arthroplast. 2006;21(6 Suppl 2):139–43.

    Article  Google Scholar 

  80. Jiang Y, Du H, Liu J, Zhou Y. Aspirin combined with mechanical measures to prevent venous thromboembolism after total knee arthroplasty: a randomized controlled trial. Chin Med J. 2014;127(12):2201–5.

    CAS  PubMed  Google Scholar 

  81. Anderson DR, Dunbar MJ, Bohm ER, Belzile E, Kahn SR, Zukor D, et al. Aspirin versus low-molecular-weight heparin for extended venous thromboembolism prophylaxis after total hip arthroplasty: a randomized trial. Ann Intern Med. 2013;158(11):800–6.

    Article  PubMed  Google Scholar 

  82. Anderson DR, Dunbar M, Murnaghan J, Kahn SR, Gross P, Forsythe M, et al. Aspirin or rivaroxaban for VTE prophylaxis after hip or knee arthroplasty. N Engl J Med. 2018;378(8):699–707.

    Article  CAS  PubMed  Google Scholar 

  83. Eriksson BI, Borris LC, Friedman RJ, Haas S, Huisman MV, Kakkar AK, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med. 2008;358(26):2765–75.

    Article  CAS  PubMed  Google Scholar 

  84. Lassen MR, Gallus A, Raskob GE, Pineo G, Chen D, Ramirez LM, et al. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. N Engl J Med. 2010;363(26):2487–98.

    Article  CAS  PubMed  Google Scholar 

  85. Hur M, Park S, Koo C, Jung ED, Kang P, Kim WH, et al. Comparative efficacy and safety of anticoagulants for prevention of venous thromboembolism after hip and knee arthroplasty. Acta Orthop. 2017;88(6):634–41.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Venker BT, Ganti BR, Lin H, Lee ED, Nunley RM, Gage BF. Safety and efficacy of new anticoagulants for the prevention of venous thromboembolism after hip and knee arthroplasty: a meta-analysis. J Arthroplast. 2017;32(2):645–52.

    Article  Google Scholar 

  87. Jameson SS, Rymaszewska M, Hui ACW, James P, Serrano-Pedraza I, Muller SD. Wound complications following rivaroxaban administration: a multicenter comparison with low-molecular-weight heparins for thromboprophylaxis in lower limb arthroplasty. J Bone Joint Surg Am. 2012;94(17):1554–8.

    Article  PubMed  Google Scholar 

  88. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, et al. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thromb Haemost. 2007;5(11):2178–85.

    Article  CAS  PubMed  Google Scholar 

  89. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet. 2007;370(9591):949–56.

    Article  CAS  PubMed  Google Scholar 

  90. Pan P, Lin P, Tang G, Lan T. Comparisons of mortality and rehospitalization between hip-fractured elderly with outpatient rehabilitation and those without: a STROBE-compliant article. Medicine (Baltimore). 2018;97(19):e0644.

    Article  Google Scholar 

  91. Frisch NB, Wessell N, Charters M, Greenstein A, Shaw J, Peterson E, et al. Hip fracture mortality: differences between intertrochanteric and femoral neck fractures. J Surg Orthop Adv. 2018;27(1):64–71.

    Article  PubMed  Google Scholar 

  92. Li Q, Dai B, Xu J, Yao Y, Song K, Zhang H, et al. Can patients with femoral neck fracture benefit from preoperative thromboprophylaxis?: a prospective randomized controlled trial. Medicine (Baltimore). 2017;96(29):e7604.

    Article  Google Scholar 

  93. Zheng G, Tang Q, Shang P, Pan X, Liu H. No effectiveness of anticoagulants for thromboprophylaxis after non-major knee arthroscopy: a systemic review and meta-analysis of randomized controlled trials. J Thromb Thrombolysis. 2018;45(4):562–70.

    Article  CAS  PubMed  Google Scholar 

  94. Schairer WW, Pedtke AC, Hu SS. Venous thromboembolism after spine surgery. Spine. 2014;39(11):911–8.

    Article  PubMed  Google Scholar 

  95. Sebastian AS, Currier BL, Kakar S, Nguyen EC, Wagie AE, Habermann ES, et al. Risk factors for venous thromboembolism following thoracolumbar surgery: analysis of 43,777 patients from the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2012. Global Spine J. 2016;6(8):738–43.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Du W, Zhao C, Wang J, Liu J, Shen B, Zheng Y. Comparison of rivaroxaban and parnaparin for preventing venous thromboembolism after lumbar spine surgery. J Orthop Surg Res. 2015;10:78.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Sansone JM, del Rio AM, Anderson PA. The prevalence of and specific risk factors for venous thromboembolic disease following elective spine surgery. J Bone Joint Surg Am. 2010;92(2):304–13.

    Article  PubMed  Google Scholar 

  98. Bryson DJ, Uzoigwe CE, Braybrooke J. Thromboprophylaxis in spinal surgery: a survey. J Orthop Surg Res. 2012;7:14.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Camporese G, Bernardi E, Prandoni P, Noventa F, Verlato F, Simioni P, et al. Low-molecular-weight heparin versus compression stockings for thromboprophylaxis after knee arthroscopy: a randomized trial. Ann Intern Med. 2008;149(2):73–82.

    Article  PubMed  Google Scholar 

  100. van Adrichem RA, Nemeth B, Algra A, le Cessie S, Rosendaal FR, Schipper IB, et al. Thromboprophylaxis after knee arthroscopy and lower-leg casting. N Engl J Med. 2017;376(6):515–25.

    Article  PubMed  Google Scholar 

  101. Imberti D, Ivaldo N, Murena L, Paladini P, Castagna A, Barillari G, et al. Venous thromboembolism in patients undergoing shoulder surgery: findings from the RECOS Registry. Thromb Res. 2014;134(2):273–7.

    Article  CAS  PubMed  Google Scholar 

  102. Jameson SS, Augustine A, James P, Serrano-Pedraza I, Oliver K, Townshend D, et al. Venous thromboembolic events following foot and ankle surgery in the English National Health Service. J Bone Joint Surg Br. 2011;93(4):490–7.

    Article  CAS  PubMed  Google Scholar 

  103. Navarro RA, Inacio MCS, Burke MF, Costouros JG, Yian EH. Risk of thromboembolism in shoulder arthroplasty: effect of implant type and traumatic indication. Clin Orthop Relat Res. 2013;471(5):1576–81.

    Article  PubMed  PubMed Central  Google Scholar 

  104. Huntley SR, Abyar E, Lehtonen EJ, Patel HA, Naranje S, Shah A. Incidence of and risk factors for venous thromboembolism after foot and ankle surgery. Foot Ankle Spec. 2019;12(3):218–27.

    Article  PubMed  Google Scholar 

  105. Fleischer AE, Abicht BP, Baker JR, Boffeli TJ, Jupiter DC, Schade VL. American College of Foot and Ankle Surgeons’ clinical consensus statement: risk, prevention, and diagnosis of venous thromboembolism disease in foot and ankle surgery and injuries requiring immobilization. J Foot Ankle Surg. 2015;54(3):497–507.

    Article  PubMed  Google Scholar 

  106. Hull R, Raskob G, Pineo G, Rosenbloom D, Evans W, Mallory T, et al. A comparison of subcutaneous low-molecular-weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation. N Engl J Med. 1993;329(19):1370–6.

    Article  CAS  PubMed  Google Scholar 

  107. Turpie AGG, Bauer KA, Eriksson BI, Lassen MR. PENTATHALON 2000 Study Steering Committee. Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip-replacement surgery: a randomised double-blind trial. Lancet. 2002;59(9319):1721–6.

    Article  Google Scholar 

  108. Eriksson BI, Bauer KA, Lassen MR, Turpie AG. Steering Committee of the Pentasaccharide in Hip-Fracture Surgery Study. Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med. 2001;345(18):1298–304.

    Article  CAS  PubMed  Google Scholar 

  109. Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Engl J Med. 2009;361(6):594–604.

    Article  CAS  PubMed  Google Scholar 

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Bass, A.R. (2020). Venous Thromboembolism and Orthopedic Surgery. In: MacKenzie, C., Cornell, C., Memtsoudis, S. (eds) Perioperative Care of the Orthopedic Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-35570-8_24

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