Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.

INTRODUCTION: Patients undergoing knee arthroplasty are at high risk of developing post-operative deep vein thrombosis (DVT) or a pulmonary embolus (PE). Despite best efforts, the best prophylaxis for thromboembolic disease remains controversial. This article aims to update the reader on the newest...

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Egile Nagusiak: Khokhar, A, Chari, A, Murray, D, McNally, M, Pandit, H
Formatua: Journal article
Hizkuntza:English
Argitaratua: 2013
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author Khokhar, A
Chari, A
Murray, D
McNally, M
Pandit, H
author_facet Khokhar, A
Chari, A
Murray, D
McNally, M
Pandit, H
author_sort Khokhar, A
collection OXFORD
description INTRODUCTION: Patients undergoing knee arthroplasty are at high risk of developing post-operative deep vein thrombosis (DVT) or a pulmonary embolus (PE). Despite best efforts, the best prophylaxis for thromboembolic disease remains controversial. This article aims to update the reader on the newest guidelines concerning venous thromboembolism (VTE) prophylaxis for elective knee arthroplasty, highlighting their inconsistencies and why variations in recommendations exist. METHODS: The Medline database and the Internet were searched for VTE prophylaxis guidelines in English. 12 guidelines were found and compared. The comparison looked at the recommendations made, the grade of recommendation, the level of evidence available for these recommendations and any inconsistencies between the guidelines. RESULTS: Nearly all the guidelines advocate the use of low molecular weight heparin (LMWH) and Fondaparinux. There is little consensus in terms of other recommended drugs, the doses, duration and their recommendation grades. There are marked differences in the methodologies adopted by the different guideline working-groups. CONCLUSION: There is still uncertainty about the optimal methods of thromboprophylaxis in elective knee arthroplasty. Although there are always going to be disagreements about the endpoints amongst guideline makers, guidelines should achieve uniformity in their reporting of end-points, criteria for levels of evidence and recommendation grades, facilitating the clinician's decision-making process.
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spelling oxford-uuid:b0d9ca15-3b1f-4ccb-bafd-681b0e13bfe82022-03-27T03:59:26ZVenous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b0d9ca15-3b1f-4ccb-bafd-681b0e13bfe8EnglishSymplectic Elements at Oxford2013Khokhar, AChari, AMurray, DMcNally, MPandit, H INTRODUCTION: Patients undergoing knee arthroplasty are at high risk of developing post-operative deep vein thrombosis (DVT) or a pulmonary embolus (PE). Despite best efforts, the best prophylaxis for thromboembolic disease remains controversial. This article aims to update the reader on the newest guidelines concerning venous thromboembolism (VTE) prophylaxis for elective knee arthroplasty, highlighting their inconsistencies and why variations in recommendations exist. METHODS: The Medline database and the Internet were searched for VTE prophylaxis guidelines in English. 12 guidelines were found and compared. The comparison looked at the recommendations made, the grade of recommendation, the level of evidence available for these recommendations and any inconsistencies between the guidelines. RESULTS: Nearly all the guidelines advocate the use of low molecular weight heparin (LMWH) and Fondaparinux. There is little consensus in terms of other recommended drugs, the doses, duration and their recommendation grades. There are marked differences in the methodologies adopted by the different guideline working-groups. CONCLUSION: There is still uncertainty about the optimal methods of thromboprophylaxis in elective knee arthroplasty. Although there are always going to be disagreements about the endpoints amongst guideline makers, guidelines should achieve uniformity in their reporting of end-points, criteria for levels of evidence and recommendation grades, facilitating the clinician's decision-making process.
spellingShingle Khokhar, A
Chari, A
Murray, D
McNally, M
Pandit, H
Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title_full Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title_fullStr Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title_full_unstemmed Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title_short Venous thromboembolism and its prophylaxis in elective knee arthroplasty: an international perspective.
title_sort venous thromboembolism and its prophylaxis in elective knee arthroplasty an international perspective
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AT charia venousthromboembolismanditsprophylaxisinelectivekneearthroplastyaninternationalperspective
AT murrayd venousthromboembolismanditsprophylaxisinelectivekneearthroplastyaninternationalperspective
AT mcnallym venousthromboembolismanditsprophylaxisinelectivekneearthroplastyaninternationalperspective
AT pandith venousthromboembolismanditsprophylaxisinelectivekneearthroplastyaninternationalperspective