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Thromboprophylaxis in major knee and hip replacement surgery: a review

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Abstract

Patients undergoing total knee and total hip replacement (THR/TKR) surgery are at high risk of venous thromboembolism (VTE), and routine thromboprophylaxis is recommended after these procedures. However, current thromboprophylaxis may require daily injections, careful anticoagulation monitoring, and dietary restrictions, which can lead to poor patient compliance and suboptimal outcomes. Therefore, there is an unmet need for simpler medication options. Newer oral anticoagulants have improved efficacy over standard treatments, with convenient dosing regimens, more predictable pharmacologic profiles that reduce the need for anticoagulation monitoring, and fewer drug or food interactions. These drugs have the potential to simplify anticoagulation after THR or TKR surgery, which may lead to improved adherence, thus lowering the incidence of VTE and associated complications after surgery.

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Acknowledgments

The authors would like to acknowledge Isabelle Leach, MBChB, who provided editorial support with funding from Janssen Scientific Affairs, LLC. Dr. Eymin does not have any financial support to disclosure.

Conflict of interest

Dr. Jaffer: Consultant: Sanofi-Aventis, Janssen Pharmaceuticals, Canyon Pharmaceuticals, Bristol Myers Squibb, and Daiichi Sankyo. Research and Grant Support: NHLBI and Astra Zeneca. Board member: Society of Perioperative Assessment and Quality Improvement and Anticoagulation Forum.

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Authors and Affiliations

  1. Division of Hospital Medicine, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA

    Gonzalo Eymin

  2. Departamento de Medicina, Grupo de Medicina Hospitalaria, Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago, Chile

    Gonzalo Eymin

  3. Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, 1138 CRB (C216), Miami, FL, 33136, USA

    Amir K. Jaffer

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  1. Gonzalo Eymin
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Correspondence to Amir K. Jaffer.

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G. Eymin and A. K. Jaffer meet criteria for authorship including acceptance of responsibility for the scientific content of the manuscript.

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Eymin, G., Jaffer, A.K. Thromboprophylaxis in major knee and hip replacement surgery: a review. J Thromb Thrombolysis 34, 518–525 (2012). https://doi.org/10.1007/s11239-012-0751-5

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