[The new guidelines for deep venous thromboembolic disease prophylaxis in elective hip and knee replacement surgery. Are we nearer or further away from a consensus?]

Rev Esp Cir Ortop Traumatol. 2012 Jul-Aug;56(4):328-37. doi: 10.1016/j.recot.2012.04.002. Epub 2012 Jun 2.
[Article in Spanish]

Abstract

Venous thromboembolism events (VTE) prophylaxis after elective hip or knee replacement surgery is a subject of controversy. Three sets of guidelines (NICE, ACCP and AAOS) on this topic have recently been updated. The guidelines have points in common: prophylaxis is necessary, it is recommended to combine mechanical and pharmacological prophylaxis in patients who have suffered a previous VTE, isolated mechanical measures and low molecular weight heparins are effective, the new oral anticoagulants and fondaparinux are effective drugs. There is some consensus in recommending regional anaesthesia, in advising against echography studies in asymptomatic patients, and in the promotion of early mobilisation of the patient. There is controversy over the most suitable pharmacological treatment and the time of starting, and the duration of this, as well as on vena cava filters, antiplatelet drugs, and VTE or bleeding risk factors.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Arthroplasty, Replacement, Hip / standards*
  • Arthroplasty, Replacement, Knee / standards*
  • Consensus
  • Elective Surgical Procedures / standards*
  • Humans
  • Perioperative Care / methods
  • Perioperative Care / standards*
  • Postoperative Complications / prevention & control*
  • Practice Guidelines as Topic*
  • Risk Factors
  • Vena Cava Filters
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*
  • Venous Thrombosis / etiology
  • Venous Thrombosis / prevention & control

Substances

  • Anticoagulants