Venous Thromboembolism Prophylaxis After Total Joint Arthroplasty

Educational Objectives As a result of reading this article, physicians should be able to: 1. Review current commonly used anticoagulant options after total joint arthroplasty. 2. Analyze the current American Academy of Orthopaedic Surgeons, American College of Chest Physicians, and Surgical Care Improvement Project guidelines for perioperative venous thromboembolism (VTE) prophylaxis after total joint arthroplasty. 3. Critically evaluate the history and most recent changes related to the current guidelines for VTE prophylaxis after total joint arthroplasty. 4. Make an informed decision on which VTE prophylaxis to use based on patient-specific factors in daily practice. Venous thromboembolism (VTE) prophylaxis after total joint arthroplasty is considered best practice. However, over the past 5 years, there has been considerable debate about the ideal prophylactic regimen or modality. The American Academy of Orthopaedic Surgeons and the American College of Chest Physicians published their most recent clinical practice guidelines about VTE prophylaxis in 2011 and 2012, respectively. In addition, the Surgical Care Improvement Project published their latest recommendations in 2014. In this review, commonly used VTE prophylaxis options and the latest clinical guidelines will be discussed. [ Orthopedics. 2015; 38(4):252–263.]