Recommendations Croatian Orthopaedic Society for thromboprophylaxis in patients undergoing major orthopedic surgery
Total arthroplasty of the hip and knee are considered to be major orthopedic surgeries. These extremely successful and purposeful surgeries are associated with a significant risk of venous thromboembolism (VTE) during the first 30 days after the surgery, thus it is necessary to perform thromboprophylaxis. Croatian Orthopaedic Society of the Croatian Medical Association has issued guidelines in order to harmonize practices in the Republic of Croatia. The Croatian Orthopaedic Society recommends the use of a low molecular weight heparin in the thromboprophylactic treatment, and it is to last throughout the first 30 days after the surgery, and not less than 15 days. It is recommended to abandon the standard practice of short-term perioperative treatment with low molecular weight heparin, followed by administration of vitamin K antagonist (typically warfarin), as the thromboprophylaxis is not entirely achieved. Also, the risk of serious / clinically relevant bleeding is higher than the risk associated with the thromboprophylaxis by lowmolecular weight heparin administered during the entire period. The recommendations also identify the value of other possibilities, including novel oral active anticoagulants that are recommended when the administration of low molecular weight heparins is not appropriate.
Key words:
arthroplasty, replacement, hip; arthroplasty, replacement, knee; venous thromboembolism; thrombosis prevention and control
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