Thromboprophylaxis after hip and knee replacement is not one size fits all. The patients most likely to clot — previous VTE, active cancer, thrombophilia, obesity, immobility — are those in whom the choice of agent matters most, and bleeding risk pulls the other way.
A documented pre-operative assessment of both, combined with early mobilisation and mechanical prophylaxis where appropriate, is established practice and makes the drug choice defensible.
- Record VTE risk factors before surgery: previous clot, cancer, thrombophilia, obesity, limited mobility.
- Record bleeding risk: anticoagulant or antiplatelet use, renal function, prior bleeding.
- Mobilise patients on the day of surgery where possible.
- Tell patients the symptoms of DVT and PE to report after discharge.
Why it matters
Most clots after arthroplasty present after discharge, when the prophylaxis decision has already been made.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for orthopaedics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free