Venous Thromboembolism Prophylaxis in Orthopedic Surgery
Gaps in Knowledge
Inadequate data did not permit conclusions about the comparative benefits and adverse effects associated with venous thromboprophylaxis in non–joint-replacement surgery.
More information is needed on the following aspects of VTE prophylaxis in the setting of major orthopedic surgery:
- Clinically important outcomes including symptomatic venous thromboembolism, post-thrombotic syndrome, clinically relevant bleeding, prosthetic infection, reoperation, and mortality and whether intermediate outcomes predict health outcomes
- Surgical, postsurgical, or patient factors that predict outcomes
- The optimal followup period needed to determine longer term outcomes
- Optimal duration of VTE prophylaxis
- The role of combined pharmacological and mechanical prophylaxis
- Sobieraj DM, Coleman CI, Tongbram V, et al. Venous Thromboembolism in Orthopedic Surgery. Comparative Effectiveness Review No. 49 (Prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under Contract No. 290-2007-10067-I). Rockville, MD: Agency for Healthcare Research and Quality; March 2012. AHRQ Publication No. 12-EHC020-EF. Available at www.effectivehealthcare.ahrq.gov/thrombo.cfm.
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