• Am J. Orthop. · Aug 2009

    Review

    Thromboprophylaxis in orthopedic surgery: how long is long enough?

    • James Muntz.
    • Baylor College of Medicine, Houston, Texas 77030, USA. jmuntz@tmhs.org
    • Am J. Orthop. 2009 Aug 1; 38 (8): 394-401.

    AbstractPharmacologic thromboprophylaxis with low-molecular-weight heparins, vitamin K antagonists, or fondaparinux is well tolerated and effective in preventing venous thromboembolism (VTE) in major orthopedic surgery but is often limited to in-hospital use. However, 45% to 80% of all symptomatic VTE events occur after hospital discharge. Extended-duration VTE prophylaxis for 28 to 35 days reduces risk for late VTE by up to 70%. In this article, I review the evidence supporting guideline recommendations regarding extended-duration prophylaxis after major orthopedic surgery and provide an overview of current and emerging literature regarding prevention of postoperative VTE in patients undergoing this surgery.

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