Venous thromboembolism following total knee replacement.

Venous thromboembolic disease (VTE) remains the most common and potentially fatal complication following total knee replacement (TKR). Its incidence has been reported in excess of 50% if no prophylaxis is used. Even with current prophylaxis regimens, VTE incidence remains high in the range of 25% to 30%. Three prophylaxis regimens are recommended according to the guidelines put forth by the American College of Chest Physicians: 1) low-molecular-weight heparin, 2) indirect factor Xa inhibitor, and 3) adjusted-dose warfarin. Phase II and III clinical trials are currently underway to evaluate the efficacy and safety of newer antithrombotic agents as prophylaxis against VTE following TKR.