Venous thromboembolism following major orthopedic surgery: Review of epidemiology and economics

Thromboprophylaxis does not prevent venous thromboembolism after major surgery

“…Our study showed a more striking difference between the incidence of PE following hip and knee arthroplasty (1.49% vs. 0%). Similarly to previous data [21,22], the highest incidence of PE in the present study (3.49%) occurred in the patients who underwent femur fracture repair. Shorr et al found the incidence of PE after major orthopedic surgery in patients receiving enoxaparin to be 2.3% [23].…”

Inherited and Acquired Risk Factors for Venous Thromboembolic Disease Among Women Taking Tamoxifen to Prevent Breast Cancer

“…11 Additional risk factors for VTE include recent surgical procedures, especially hip replacement surgery and major surgery involving the abdomen, pelvis, and lower extremities; prolonged immobility; stroke; and trauma (especially fractures of the pelvis, hip, or leg). 12,13 Finally, smoking and obesity also seem to be associated with increased risk of developing a VTE, [14][15][16][17] although it seems that these risk factors may be of lesser importance than the factor V Leiden mutation or estrogen use. 15 The most common inherited risk factor for VTE is a G1691A mutation in the factor V gene, resulting in the substitution of Arg5063 Gln, and hence the loss of one of three activated protein C (APC) cleavage sites in factor V. [18][19][20][21] This leads to the phenomenon of resistance to the anticoagulant activity of APC, and is associated with a significantly increased risk of thrombosis: approximately seven-fold for heterozygous individuals and 80-fold for homozygous individuals.…”

Low-Molecular-Weight Heparin Prophylaxis in Major Orthopaedic Surgery of the Lower Extremity

“…3 More recently, in 2001, the estimate for treating VTE over a lifetime was estimated at $11,600. 6 The more VTE events prevented, the lower the cost both in dollars and in life disruptions. The use of LMWH can prevent many VTE events, decreasing risk of VTE over placebo in THR by 78%, in TKR by 63%, and in hip fracture surgery by 44%.…”