Venous Thromboembolism Prophylaxis in Total Knee Arthroplasty and Total Hip Arthroplasty

Prevention of venous thromboembolism (VTE) in the surgical patient is a paramount medical issue. VTE is superseded only by infection as the most common medical complication causing increased length of stay for surgical patients. All total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients should be assessed for an appropriate VTE prophylaxis strategy. Preferred pharmacoprophylaxis options currently include warfarin, low molecular weight heparin, fondaparinux, and rivaroxiban. Mechanical prophylaxis is recommended in all patients who are undergoing THA or TKA and are at increased risk of bleeding whereby chemoprophylaxis is contraindicated.