Risk Stratification for Venous Thromboembolism Prophylaxis

Orthop Clin North Am. 2025 Apr;56(2):155-163. doi: 10.1016/j.ocl.2024.09.003.

Abstract

Current risk stratification scores provide some guidance in determining the possibility of a venous thromboembolism (VTE) event following total joint arthroplasties (TJA). The current literature supports low-dose aspirin of 81 mg twice daily as an ideal thromboprophylaxis agent for low-risk patients undergoing elective primary or revision total hip arthroplasty and total knee arthroplasty. Anticoagulants are suggested for high-risk patients. Intermittent mechanical compression and early mobilization are mechanical factors that can contribute to the reduction of VTE following major orthopedic surgeries. Surgeons should consider classification of TJA patients in low-risk or high-risk patients based upon validated risk assessment modules.

Keywords: Arthroplasty VTE; Arthroplasty VTE prophylaxis; VTE risk stratification.

Publication types

  • Review

MeSH terms

  • Anticoagulants* / therapeutic use
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use
  • Humans
  • Postoperative Complications* / prevention & control
  • Risk Assessment
  • Risk Factors
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control

Substances

  • Anticoagulants
  • Aspirin