TITLE:
Challenges of Anticoagulation in Total Joint Arthroplasty
AUTHORS:
Anshul Sobti, Ashwin Unnithan
KEYWORDS:
DVT, Anticoagulation, VTE, Total Joint Arthroplasty, TJA, Revision Arthroplasty
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.10 No.10,
October
22,
2020
ABSTRACT: Aggressive anticoagulation following total joint arthroplaty (TJA) is
well known to increase the risk of both wound leakage and hematoma formation.
Despite this there are no guidelines for orthopaedic surgeons undertaking major
primary and revision surgery in patients with high risk of venous thromboembolic
events, who may present with complications directly linked to anticoagulant
use. Hence the authors felt the need for this narrative review. They have tried
to answer few questions that are commonly faced in clinical practice. Balanced
anticoagulation is a difficult task to achieve. The potential consequences of
over anticoagulation on the outcome of TJA and revision TJA are live changing
and devastating. On the contrary falling short of adequate anticoagulation is
fatal leading to recurrent thromboembolic events. Robust risk stratification
tools and a multidisciplinary approach are certainly the way forward. There is an urgent need for specialty
specific guidelines for managing patient on anticoagulation undergoing TJA, and
revision arthroplasty procedures.