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Orthopedic Surgery

Venous Thromboembolism (VTE) is one of the known complications of major orthopedic surgery which includes total knee, total hip replacements, and hip fracture surgery. According to the American College of Chest Physicians (ACCP) the risk of hospital acquired deep vein thrombosis (DVT) without prophylaxis for orthopedic surgery patients is 40-60%, and the risk of pulmonary embolism (PE) is 0.9-11%. These numbers can be increased if there are additional risk factors present before surgery. Patients that develop DVT post surgery can have increased hospital stays and medical charges for up to 3 months.

Talk to your doctor about your risk and ways to prevent VTE before and after major Orthopedic surgeries.

Risk of DVT Without Prevention
  • After Total Hip Replacement- 45-57%
  • After Total Knee Replacement- 41-85%
  • After Hip Fracture Surgery- 46-60%

Additional Risks
  • Advanced Age
  • Obesity
  • Smoking
  • Prolonged Immobilization (> 72 hours)
  • Venous Insufficiency
  • Obstructed Circulation
  • Endothelial Damage to the vessels from positioning during surgery
  • Varicose Veins

Prevention
  • Early Ambulation
  • Compression Stockings
  • Intermittent Pneumatic Compression devices
  • Low Molecular Weight Heparins
Recommendations
Depending on the type of surgery the ACCP recommends the use of anticoagulation for up to 6-12 weeks post surgery.

IVC filters should be placed in patients that are unable to be placed on anticoagulation medications, developed clots while taking anticoagulants, or are at increased risk for bleeding.

References
IVC Filter Clinic | Northwestern Medicine