Abstract
Venous thromboembolic disease (VTED) is a major cause of morbidity and mortality after
total knee arthroplasty (TKA). Current VTED prophylaxis protocols consist of early
mobilization, mechanical compression devices, and pharmacologic agents. Venous phasic
flow-regulated below-knee devices are generally favored, but the optimal duration
and method of mechanical prophylaxis is unknown. Risk stratification models have been
developed to guide pharmacologic prophylaxis. For patients with standard VTED risk
profile, aspirin has become increasingly popular. Recent studies have validated the
efficacy, relatively low bleeding risks, and cost-effectiveness of aspirin in the
patients with standard risk profile. Current evidence suggests that the newer oral
anticoagulants, including the factor Xa and the direct thrombin inhibitors, are effective
for the reduction of postoperative VTED but may be associated with increased bleeding
and wound complication rates.
Keywords
total knee arthroplasty - venous thromboembolism prophylaxis - total knee arthroplasty
complications
