Orthopedic Surgery VTE Prophylaxis

Question 1

UFH for VTE prophylaxis orthopedic surgery

Answer 1

UFH has consistently shown insufficient protection against VTE in patients undergoing orthopedic surgery

Question 2

VTE prophylaxis knee arthroscopy

Answer 2

typically do not need VTE prophylaxis beyond early mobilization unless they have additional VTE risk factors or have a complicated procedure. In those cases, patients should receive VTE prophylaxis with an LMWH.

Question 3

elective spinal surgery VTE prophylaxis timing

Answer 3

typically be initiated 12–24 hours postoperatively.
Prophylaxis may need to be delayed if the surgical site remains open

Question 4

elective spinal surgery VTE prophylaxis indication

Answer 4

generally not recommended unless patients have additional risk factors of advanced age, malignancy, neurologic deficit, previous VTE, or an anterior surgical approach. recommendations are general and include SC UFH or LMWH

Question 5

enoxaparin VTE Prophylaxis in Orthopedic Surgery

Answer 5

Knee or Hip replacement, hip fracture - 30 mg SC q12hr initiated 12–24 hr after surgery
Hip replacement-40 mg SC q24hr initiated10–12 hr before surgery

Question 6

Dalteparin VTE Prophylaxis in Orthopedic Surgery

Answer 6

Knee or Hip replacement - 2500 IU SC given 6–8 hr after surgery; then 5000 IU SC q24hr
Hip repalcement - 5000 IU SC q24hr initiated the evening before surgery

Question 7

Fondaparinux VTE Prophylaxis in Orthopedic Surgery

Answer 7

Knee or Hip replacement; hip fracture - 2.5 mg SC q24hr initiated 6–8 hr after surgery

Question 8

Warfarin VTE Prophylaxis in Orthopedic Surgery

Answer 8

Initiated preoperatively or the evening of the surgical day with adjusted dosing to achieve a target INR of 2-3

Question 9

Dabigatran VTE Prophylaxis in Orthopedic Surgery

Answer 9

Hip replacement - 110 mg initiated 1–4 hr after surgery; then 220 mg once daily

Question 10

Rivaroxaban VTE Prophylaxis in Orthopedic Surgery

Answer 10

Knee or Hip replacement - 10 mg once daily initiated 6–10 hr after surgery

Question 11

Apixaban VTE Prophylaxis in Orthopedic Surgery

Answer 11

Knee or Hip replacement - 2.5 mg twice daily, initiated 12–24 hr after surgery

Question 12

Total knee replacement surgery Duration of VTE Prophylaxis

Answer 12

At least 10 days

Question 13

Total hip replacement surgery Duration of VTE Prophylaxis

Answer 13

4–6 wk

Question 14

Hip fracture surgery Duration of VTE Prophylaxis

Answer 14

4–6 wk