TY - JOUR
T1 - Aggressive anticoagulation after TJA
T2 - An evaluation of the ACCP guidelines for thromboprophylaxis
AU - Parvizi, Javad
AU - Kahl, Lauren K.
AU - Dalsey, Chelsea
PY - 2007
Y1 - 2007
N2 - Thromboembolic disease is common after orthopaedic surgery. In an effort to minimize the risk of pulmonary embolism and deep vein thrombosis (DVT), anticoagulation administration has become a common practice. Both the American College of Chest Physicians (ACCP) and the American Association of Orthopaedic Surgeons (AAOS) have published guidelines recommending antithrombotic protocols. The ACCP guidelines are excessive and do not adequately evaluate the complications resulting from aggressive anticoagulation. These complications include, but are not limited to, major and minor bleeding events, thrombocytopenia, subsequent periprosthetic infection, and complications with spinal or epidural anesthesia. The AAOS guidelines generated by a group of orthopedic surgeons evaluate the efficacy of various agents in preventing pulmonary embolus and not distal DVT. They differ from the AACP guidelines in some aspects. The AAOS guidelines accept the use of aspirin combined with mechanical compression devices, and low-dose warfarin therapy. We believe that the AAOS guidelines for thromboprophylaxis take into account all risks associated with anticoagulation therapy and may prove to be a safer option for our patients.
AB - Thromboembolic disease is common after orthopaedic surgery. In an effort to minimize the risk of pulmonary embolism and deep vein thrombosis (DVT), anticoagulation administration has become a common practice. Both the American College of Chest Physicians (ACCP) and the American Association of Orthopaedic Surgeons (AAOS) have published guidelines recommending antithrombotic protocols. The ACCP guidelines are excessive and do not adequately evaluate the complications resulting from aggressive anticoagulation. These complications include, but are not limited to, major and minor bleeding events, thrombocytopenia, subsequent periprosthetic infection, and complications with spinal or epidural anesthesia. The AAOS guidelines generated by a group of orthopedic surgeons evaluate the efficacy of various agents in preventing pulmonary embolus and not distal DVT. They differ from the AACP guidelines in some aspects. The AAOS guidelines accept the use of aspirin combined with mechanical compression devices, and low-dose warfarin therapy. We believe that the AAOS guidelines for thromboprophylaxis take into account all risks associated with anticoagulation therapy and may prove to be a safer option for our patients.
KW - Guidelines
KW - Pulmonary embolism
KW - Thromboprophylaxis
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U2 - 10.1615/JLongTermEffMedImplants.v17.i4.90
DO - 10.1615/JLongTermEffMedImplants.v17.i4.90
M3 - Review article
C2 - 19267690
AN - SCOPUS:62449310568
SN - 1050-6934
VL - 17
SP - 359
EP - 365
JO - Journal of long-term effects of medical implants
JF - Journal of long-term effects of medical implants
IS - 4
ER -