AI Article Synopsis
- Total hip replacement (THR) and total knee arthroplasty (TKA) are associated with a significant risk of postoperative venous thromboembolism (VTE), prompting the recommendation of anticoagulation prophylaxis, yet no guidelines exist for hemophilia patients undergoing these surgeries.
- A retrospective study of 23 hemophilia patients who underwent elective THR/TKA found that a majority did not receive adequate VTE prophylaxis, with only a few using sequential compression devices or prophylactic medication.
- After one year of follow-up, there were no reported cases of clinical VTE among the patients, highlighting the need for improved risk assessment strategies for better VTE management in this specific population.
Article Abstract
Total hip replacement (THR) and total knee arthroplasty (TKA) carry a high risk of postoperative venous thromboembolism (VTE); therefore, anticoagulation prophylaxis is recommended in these patients. Unfortunately, there are no guidelines about VTE prophylaxis in patients with hemophilia who underwent these high-risk surgeries. To determine whether these patients have high risk of VTE, we conducted a retrospective study on patients with hemophilia who underwent elective THR/TKA at our institute from 2004 to 2012. Postoperatively, we collected information on duration and method of factor VIII/IX infusion, VTE-prophylaxis, and complications. There were 23 patients with hemophilia, 18 (78%) with hemophilia A and 5 (22%) with hemophilia B, who underwent high-risk surgeries (39% THR and 61% TKA). The VTE prophylaxis included sequential compression device, 12 (52%), and prophylactic enoxaparin, 1 (4%). Ten (43%) patients did not receive VTE prophylaxis. At 1-year follow-up, we did not find any evidence of clinical VTE in our patients. Better risk stratification is needed to identify patients who would benefit from pharmacological prophylaxis.
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| http://dx.doi.org/10.1177/1076029614543139 | DOI Listing |
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