What are the AAOS guidelines for preventing venous thromboembolism (VTE) in patients undergoing elective hip and knee arthroplasty?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Guidelines from the American Academy of Orthopaedic Surgeons (AAOS) on preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty included the following recommendations [7] :

  • Recommend against routine postoperative duplex ultrasonography screening
  • Assess risk of previous VTE
  • Assess risk for bleeding
  • Suggest discontinuance of antiplatelet agents before undergoing elective hip or knee arthroplasty
  • Suggest pharmacologic agents and/or mechanical compressive devices for prevention of VTE in those undergoing elective hip or knee arthroplasty who are not at elevated additional risk for VTE or bleeding
  • Pharmacologic prophylaxis and mechanical compressive devices for those who have had previous VTE and are undergoing elective hip or knee arthroplasty
  • Mechanical compressive devices for those who have had known bleeding disorder and/or active liver disease and are undergoing elective hip or knee arthroplasty
  • Patients should undergo early mobilization following elective hip and knee arthroplasty
  • Use of neuraxial anesthesia for those undergoing elective hip or knee arthroplasty to help limit blood loss
  • Unable to recommend for or against the use of inferior vena cava filters

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