ArticleBMC musculoskeletal disorders2024
The incidence of venous thromboembolism is low when risk stratification-based thromboprophylaxis is used after fast-track hip and knee arthroplasty.
Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of extended duration pharmacological thromboprophylaxis on venous thromboembolism after hip and knee arthroplasty and hip fracture surgery: a systematic review and meta-analysis of randomised controlled trials.Journal of thrombosis and thrombolysis · 2026Pooled it
- Machine learning-based prediction of postoperative venous thromboembolism in orthopedic surgery using the MIMIC-IV database and external validation.Frontiers in surgery · 2026Article
- Development and validation of a risk prediction model for postoperative pneumonia in elderly non-cardiac surgery patients: a retrospective cohort study.Scientific reports · 2025Article
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6 authors.
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Abstract
backgroundThe optimal length of thromboprophylaxis after total hip or knee arthroplasty (THA and TKA) is unknown. Fast-track protocols have improved patient care and led to shorter immobilization and length of stay (LOS) after THA and TKA, thereby diminishing venous thromboembolism (VTE) risk. Here, we investigated risk stratification-based thromboprophylaxis after fast-track THA and TKA.
methodsA retrospective register study was conducted in two Finnish hospitals using a fast-track protocol for THA and TKA. These hospitals use risk stratification-based planning of thromboprophylaxis, including risk evaluation of patients' personal VTE risk. Patients at low risk received thromboprophylaxis solely during hospitalization, provided this lasted five days or less. All VTEs and clinically relevant bleedings were obtained from Finnish hospital discharge registers between 1 January 2020 and 31 December 2021 to determine VTE incidences and clinically relevant bleedings 90 days after surgery.
resultsDuring the study period 3 713 arthroplasties were performed (1 636 THAs and 2 077 TKAs). The 90-day incidence of VTE was 0.7% (CI 0.4 to 0.9), and 25 VTEs occurred within 90 days of surgery. These VTEs comprised 12 pulmonary embolisms and 13 deep vein thromboses, none of which was fatal. The incidence of clinically relevant bleedings (n = 57) within 90 days of surgery was 1.5% (CI 1.1 to 1.9). One intracranial bleeding was fatal. The bleedings typically occurred at the operational site.
conclusionRisk stratification-based thromboprophylaxis appears safe for fast-track THA and TKA patients as the incidences of VTEs and clinically relevant bleedings were low.
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