Staged venous thromboemolic events prophylaxis with low-molecular-weight heparin followed by aspirin is safe and effective after arthroplasty.

Background: The rate of fatal pulmonary embolism (PE) following hip and knee arthroplasty has remained unchanged despite the use of low-molecular-weight heparin (LMWH) and oral antithrombotic agents. Concerns regarding bleeding and wound complications resulted in the introduction of a staged chemoprophylaxis protocol at our institution in 2002. We hypothesized that staged chemoprophylaxis using LMWH in hospital followed by aspirin after discharge was safe and effective for the prevention of venous thromboembolic events (VTE).