Thromboprophylaxis in major knee and hip replacement surgery: a review

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.