School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Vascular Surgery, General Hospital of Athens G. Genimatas, Athens, Greece.
Curr Pharm Des. 2022;28(10):771-777. doi: 10.2174/1381612828666220418090928.
Venous thromboembolism (VTE) is a serious complication after major orthopaedic operations, such as a total hip (THA) and knee (TKA) arthroplasty. Therefore, perioperative VTE prophylaxis is recommended; a multitude of modern options are available, including both pharmacologic (aspirin, unfractionated and lowmolecular- weight heparin, vitamin K antagonists, and novel oral anticoagulants) and/or mechanical interventions (early mobilization, graduated compression stockings, intermittent pneumatic compression devices, and venous foot pumps). However, because of the abundance of these possibilities, it is crucial to understand the benefits and drawbacks of each VTE prophylaxis option to ensure that the optimal treatment plan is developed for each patient. The American College of Chest Physicians (AACP) and the American Academy of Orthopaedic Surgeons (AAOS) have both published individual guidelines on VTE prophylaxis regimens, alongside numerous studies evaluating the efficacy and outcomes of the different prophylaxis modalities. The purpose of this review is to provide a summary of the evidence on VTE prophylaxis after elective total hip and knee arthroplasty based on current guidelines and highlight the major concerns and potential complications.
静脉血栓栓塞症（VTE）是大型骨科手术后的严重并发症，如全髋关节（THA）和膝关节（TKA）置换术。因此，建议进行围手术期 VTE 预防；有多种现代选择，包括药物（阿司匹林、未分级和低分子量肝素、维生素 K 拮抗剂和新型口服抗凝剂）和/或机械干预（早期活动、分级压缩袜、间歇性气动压缩装置和静脉足泵）。然而，由于这些可能性很多，了解每种 VTE 预防措施的优缺点至关重要，以确保为每个患者制定最佳治疗计划。美国胸科医师学会（AACP）和美国骨科医师学会（AAOS）都发布了关于 VTE 预防方案的单独指南，以及许多评估不同预防方式疗效和结果的研究。本综述的目的是根据当前指南提供关于择期全髋关节和膝关节置换术后 VTE 预防的证据总结，并强调主要关注点和潜在并发症。
