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VTE AND YOUR PATIENTS

VTE Is the Most Frequent Serious
Complication Following Hip
Replacement and Knee
Replacement Surgery.1

Deep vein thrombosis is the most common type of VTE, which can lead to pulmonary embolism (PE), a potentially life-threatening condition.2


 


hip replacement surgery

FACT:

VTE is the most common cause for readmission to the hospital following hip replacement surgery.1


The recommended approach to decrease probability of VTE in patients undergoing orthopedic surgery is by preventing it before it occurs.1,3

Assessing the Risk of VTE in Postsurgical Orthopedic
Patients

Orthopedic surgery involving the hip or knee is associated with approximately 40% to 60% risk of DVT in nonprophylaxed inpatients compared with 15% to 40% of patients undergoing general surgery. Stasis of venous blood flow from postoperative immobility, direct injury to vein walls during surgery, and impairment to the coagulation system may all account for this increased risk.1

During the 19th century, the German pathologist Rudolf Virchow first theorized that thrombus formation originated from abnormalities occuring in the circulatory system.4

Virchow's triad, as it is known today, consists of 3 factors that are thought to contribute to thrombosis2,4,5:

  • Venous stasis—slowing of blood flow
  • Vascular injury—damage to the vein
  • Hypercoagulability—changes in the blood that result in an increased tendency to form clots


Vascular Injury



References:

  1. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133(suppl 6):381S-453S. doi:10.1378/chest.08-0656.
  2. Bates SM, Ginsberg JS. Treatment of deep-vein thrombosis. N Engl J Med. 2004;351(3):268-277.
  3. American Academy of Orthopaedic Surgeons clinical guideline on prevention of pulmonary embolism in patients undergoing total hip or knee arthroplasty. http://www.aaos.org/Research/guidelines/PE_guideline.pdf. Published 2007. Accessed February 1, 2011.
  4. Merli GJ. Pathophysiology of venous thrombosis, thrombophilia, and the diagnosis of deep vein thrombosis-pulmonary embolism in the elderly. Clin Geriatr Med. 2006;22:75-92. doi:10.1016/j.cger.2005.09.012.
  5. Mannucci PM, Poller L. Historical review: venous thrombosis and anticoagulant therapy. Br J Haematol. 2001;114:258-270.
  6. Ridings HD, Holt L, Cook R, Marques MB. Genetic susceptibility to VTE: a primary care approach. JAAPA. 2009;22(7):20-25.
  7. Rosendaal FR. Risk factors for venous thrombosis: prevalence, risk, and interaction. Semin Hematol. 1997;34(3):171-187.