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Preventing VTE following total hip and knee arthroplasty: Is prediction the future?
Author(s) -
Nemeth Banne,
Nelissen Rob,
Arya Roopen,
Cannegieter Suzanne
Publication year - 2021
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.15132
Subject(s) - medicine , venous thromboembolism , total knee arthroplasty , arthroplasty , total hip arthroplasty , complication , major bleeding , psychological intervention , surgery , intensive care medicine , physical therapy , thrombosis , psychiatry , myocardial infarction
Venous thromboembolism (VTE) is a common complication following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Many guidelines advise on the ideal pharmacological thromboprophylaxis strategy; however, despite its use, approximately 1.5% of patients still develop symptomatic VTE. Considering the large number of THAs and TKAs performed worldwide (2.5 million in total), the impact of VTE following these interventions is enormous. This paper discusses a concept how to further lower rates of VTE and bleeding complications following surgery. By stratifying patients according to their risk, we can optimize the balance between VTE and bleeding for each individual. This way, low‐risk patients may be safely withheld from treatment (and avoid unnecessary bleeding complications and costs), whereas high‐risk patients should receive adequate therapy (for instance, an increased thromboprophylaxis dosage and duration). An individualized strategy requires a well‐functioning VTE prediction model following THA and TKA to help physicians to decide on optimal thromboprophylaxis therapy.